Thyroid Eye Disease

What are Thyroid Gland Disorders?

The thyroid gland, located in the neck, produces thyroid hormone which helps regulate our metabolism. It may produce either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism). Imbalance in either direction can cause eye and vision problems.

Symptoms of hyperthyroidism include fatigue, fast heartbeat, weight loss, heat intolerance, fine hair and diarrhea. Hypothyroidism may also cause fatigue but with slow heartbeat, constipation and weight gain.

What are they Symptoms of Thyroid-related eye problems?

A “staring” appearance and dry eyes are often the first symptoms. Early signs include swelling of the eyelids and tissues around the eyes. Swelling of the normal fatty tissue surrounding the eye can push the eye forward creating a prominence or protrusion of the eye. The degree of protrusion is variable and may involve one or both eyes. Swelling of the muscles which move the eyes may produce double vision. In severe cases the clear covering of the eye (cornea) may ulcerate, or the optic nerve may be damaged which results in a permanent loss of vision.

Can Thyroid Eye Disease Occur Even if Thyroid Function Tests are Normal?
   
YES! Protrusion and other symptoms of thyroid eye disease may be present even when tests show abnormal level of thyroid hormone in the blood. However, most patients with eye symptoms have abnormal levels of thyroid hormone.

How is Thyroid Eye Disease Treated?

Once an overactive thyroid gland is suspected, the thyroid function must be evaluated and appropriately treated. The eye disease may continue to progress after the thyroid function is treated and returned to normal. Any residual eye problems should be followed and treated by an ophthalmologist.

Two phases of eye treatment should be considered. The first phase involves treating the active eye disease. The active period, which usually lasts two or more years, requires careful monitoring until stable. The second phase involves correcting unacceptable permanent changes which persist following stabilization of the active phase.

Treatment during the active phase of the disease focuses on preserving sight. Medical treatment such as artificial tears and ointments, high does of cortisone (steroids), orbital surgery and possible radiation of the orbit may be required. In the second phase treatment of permanent changes may require surgical correction of double vision, staring appearance or eye protrusion.