Thyroid Eye Disease

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Graves’ thyroid disease causes inflammation and swelling of the fat and muscles surrounding the eyes. While for some patients it shoes itself in swelling or red eyes, in others it causes a retraction of the eyelids or a protrusion of the eyes.

Symptoms of Thyroid Eye Disease

There are many ways in which the eyes may be affected by Graves’ disease.  Some possible symptoms include:

  • Red, swollen, painful eyes
  • Protrusion of the eyes
  • Opening (retraction) of the eyelids that may result in a “staring” appearance
  • Excessive tearing
  • Blurred vision
  • Sensitivity to light
  • Sn inability to close the eyes completely
  • Crossing of the eyes
  • Loss of vision

Patients who smoke cigarettes are known to be at greater risk for serious complications of thyroid eye disease.  Smokers who develop Graves’ disease must stop smoking.

How Graves’ Disease Is Diagnosed

The diagnosis of Graves’ disease is usually made by blood tests.   In some cases, Graves’ disease may affect the eyes long before blood tests become abnormal, and, in other situations, the blood tests never become abnormal, which is a condition known as euthyroid Graves’ disease.  While it is important for your primary care physician or endocrinologist to treat and control the Graves’ disease so that thyroid hormone levels return to normal, normalization of the blood tests does not necessarily prevent continued progression of eye changes.

Treatment of Graves’ Eye Disease

Treatment of Graves’ eye disease may include treatment of thyroid hormone levels measured in the blood, and/or medicine, radiation therapy or surgery to treat the eyes.  The severity of the condition will determine which treatment or treatment combination is most appropriate.  It is not uncommon for several surgical procedures to be required to achieve maximum improvement in visual function and appearance of the eyes.  These procedures may include decompression (removal of bone from the walls of the eye socket), adjustment of the muscles that control movement of the eyes and eyelid surgery to reposition the lids and remove excess skin and fat.  These procedures are typically performed over a period of several months.

What to Expect from Surgery

Surgeries performed to correct the changes associated with Graves’ disease are performed on an outpatient basis.  Therefore overnight hospitalization is not required.  There is typically very little discomfort after Graves’ eye disease correction, but swelling and bruising will be present.  Most patients who work choose to take about a week off for recovery.

Quick Facts:

  • Graves’ disease causes inflammation of the muscles and fat around the eyes
  • Symptoms may include “bulging” of the eyes, redness, pain, irritation, decreased vision, double vision and others
  • Smokers who have Graves’ disease are at risk for more serious complications and thus must discontinue smoking
  • Treatment for Graves’ eye disease may include medication, radiation and/or surgery