Eye problems

Information about eye problems as a result of thyroid diseases.

Eye problems

Eye problems

General
People with Graves’ disease (overactive thyroid gland) may also develop eye problems. This is also called Graves’ orbitopathy or ophthalmopathy. The eye disease is caused by an autoimmune inflammation of the tissue behind and around the eye. The eye symptoms usually occur at the same time that an overactive thyroid is diagnosed, but they can also occur later in the course of the thyroid disease. Sometimes, the eye disease can also occur in patients who do not have an overactive thyroid.

Symptoms
The symptoms that can occur as a result of Graves’ eye disease range from mild to very severe. Typical symptoms include:

  • Red eyes/eyelids
  • Watering eyes
  • Feeling of grittiness of the eyes
  • Pressure behind the eyes
  • Bulging eyes
  • Sensitivity to light
  • Swollen eyelids
  • Double vision
  • Pain when moving the eyes
  • Loss of vision

Testing and diagnosis
The ophthalmologist will often be able to make a diagnosis based on the symptoms, a physical examination, and a thorough ophthalmic examination. Sometimes an additional scan (CT scan or MRI scan) of the eye will be required to make a proper diagnosis.

Treatment
The ophthalmologist and internist/endocrinologist will treat the eye disease in coordination with each other. It is important that the thyroid levels are regulated properly in order to treat the eye disease. Smoking is also strongly discouraged as this is a risk factor for developing the eye disease. In the case of mild symptoms, artificial tears are prescribed to counteract dryness of the eyes and selenium supplements are sometimes recommended. In more severe cases, the treatment consists of corticosteroids or other immunosuppressants (drugs that suppress the immune system). Surgery or additional radiation therapy may be required if the treatment does not have the desired effect. Once the eye disease has passed, additional eye surgery may be necessary to correct any abnormalities that have developed.

Click here for the patient leaflet (Dutch) on Graves’ eye disease published by the Dutch Association for Endocrinology (NVE).

Click here for the Rotterdam Eye Hospital’s patient leaflets (Dutch) about Graves’ eye disease.

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