Grave’s Ophthalmology or Thyroid Eye Disease is an autoimmune condition that happens when the thyroid gland is not functioning the way it should due to the immune system attacking the thyroid gland. Commonly also known as Graves' eye disease, the problem causes inflammation and damage to the tissues around the eye. While most people with Grave’s ophthalmology have a thyroid gland that makes too much hormone, some individuals affected with TED have a scarcity of this hormone in their bodies.

Also Read: Bulging Eyes: Causes, Symptoms And Treatment

Causes

The following can be the primary causes of thyroid eye disease:

  • Exophthalmos (also known as proptosis)- a medical term for protruding eyeballs
  • Excessive smoking
  • A visible family history of thyroid eye disease
  • Grave's Disease

Also Read: Grave’s Disease – Causes, Symptoms And Treatment

Symptoms Of Thyroid Eye Disease

Symptoms of Graves' eye disease can vary among individuals and may come and go from time to time. Some common ones are:

Protruding eyes: Thyroid eye disease 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 staring at you.

Gritty Feeling: The person who is affected may feel that there is something inside one eye or both eyes accompanied by low tolerance to bright lights.

Visible Eyelid Retraction: When the eye is pushed forward, the upper and lower eyelids retract automatically retract themselves making the white part of the eye more visible.

Dry Eyes: Due to excessive bulging the eyes are more exposed to wind and dust. This can make the eyes prone to dryness, uncomfortable that may make the vision blurry.

Vision Changes. Muscle swelling can cause double vision. Inflamed muscles can create pressure and damage the optic nerve.  In the long run, it can lead to vision loss.

Bags Around Eyes:  When the eyelid swells up, the tissue around the eye bulges. This looks like bags around the eyes and makes them appear tired.

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How Is Thyroid Eye Disease/ Graves' Eye Disease Treated?

Mild to moderate Graves' ophthalmopathy cases are treatable and patients experience improvement over the course of two to three years. Surgery to improve eyelid retraction is not recommended until the disease is in its stable phase. By and large, to let the eye go back into its normal position the following measures are taken:

  • Topical eye drops are given to treat ocular surface disease at the onset of the disease
  • Steroids are given to reduce symptoms and to control eye muscle swelling
  • Fix eyelid retraction is a method that is adopted to relieve dry eye and improve the appearance of the eyes thus preventing vision loss. This helps improve vision and bulging eyes besides letting eye muscles work better
  • For double vision, the doctor may prescribe special eyeglasses with prism correction to restore normal vision
  • Surgery is done to reposition the eye or the muscles of the eye or to remove parts of the eye socket bone
  • While thyroid eye disease primarily affects the tissues, significant changes in the skin and fat in the eyebrows, cheeks, and neck can be seen which can be addressed with cosmetic invasions. A combination of lasers, fillers, botox, or surgery for the eyelid, eyebrow, neck, and face can be considered.

Lifestyle Changes To Alleviate Thyroid Eye Disease

Following lifestyle measures can go a long way to reduce the discomfort arising from this eye ailment:

  • Use lubricating ointment to soothe dry eyes
  • Wear sunglasses to help with light sensitivity
  • To reduce irritation, apply cool compression on the eyes
  • Quit smoking
  • Reduce stress with regular exercise

References:

  1. Marcocci C, Kahaly GJ, Krassas GE, et al. Selenium and the course of mild Graves’ orbitopathy. N Engl J Med 2011;364:20:1920-31.
  2. Ramesh S, Eichhorn K, Leibowitz S, Goldberg R. Bony regrowth after deep lateral orbital decompression.
  3. https://www.reviewofophthalmology.com/article/management-of-thyroid-eye-disease

Disclaimer:

The content provided here is for informational purposes only. This blog is not intended to substitute for medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions or concerns you may have regarding a medical condition. Reliance does not endorse or recommend any specific tests, physicians, procedures, opinions, or other information mentioned on the blog.