The thyroid is a gland in the front of your neck. It makes hormones to help control your metabolism, which is how your body turns food into energy. Some people have a condition where their body’s immune system attacks the thyroid gland. When this happens, their thyroid gland produces too much hormone. This is called hyperthyroidism, or Graves’ disease. When Graves’ disease affects the eyes, the condition is known as thyroid eye disease. Graves’ disease affects muscles and tissue surrounding the eyes.
Graves' Disease Symptoms
How Does Graves' Disease Affect the Eyes?
Too much thyroid hormone can cause eye and vision problems in some people. Symptoms are different among people, and they can come and go.
Here are some of the problems.
When the muscles around the eye swell and push the eye forward, the upper and lower eyelids are pulled or retracted. The white parts of the eye become more visible.
Having too much thyroid hormone causes the muscles in and around the eye to swell and push the eye forward. This eye bulge makes someone look as if they are constantly staring. It is a common symptom of Graves’ disease.
With eyelid retraction and eye protrusion, the eyes are exposed to wind and dust. This can make the eyes very dry. Dry eye makes the eyes feel very scratchy and uncomfortable, and makes vision blurry. Being very sensitive to light is also a problem. Severe dry eye can eventually damage the cornea, the clear, front window of the eye.
Muscle swelling can cause double vision. That swelling can also lead to pressure on the optic nerve. That is the nerve connecting the eye to the brain. When the optic nerve is damaged, it causes blindness.
When the eyelid swells, it can cause tissue around the eye to bulge. This looks like “bags” around the eyes, and can make someone look older than they are.
Graves' Disease Treatment
Your ophthalmologist will examine your eyes and keep track of your symptoms. If your eyes continue to protrude or eyelids retract, treatment may be needed.
Here are some treatment options:
Smoking can make symptoms worse. Quitting smoking may help relieve the severity of your symptoms.
There is a new medicine (Teprotumumab-trbw) available to treat Graves’ disease. This medicine:
- is given by infusion (put in body through a vein)
- helps relieve eye symptoms associated with thyroid eye disease
- may eliminate the need for some corrective eye surgeries
Your ophthalmologist may recommend surgery to help fix eye muscle problems from Graves’ disease. Here are some surgery options:
- Reposition eyelid muscles to fix eyelid retraction, relieving dry eye and improving how the eye looks
- Reposition the eye, the eye muscles or both to help improve vision and the bulging eye appearance
- Remove scar tissue from eye muscles to improve how those muscles work
- Relieve pressure on the optic nerve to prevent vision loss
If you have Graves’ disease, talk with your ophthalmologist about ways to relieve your symptoms.