Your thyroid gland governs your production of thyroid hormone. Overproduction or underproduction of thyroid hormone can affect your metabolism, your mood, and even your eyes. If you have thyroid eye disease, also known as Graves’ eye disease, overproduction of thyroid hormone in response to an autoimmune attack can ultimately threaten your vision.
Our renowned oculoplastic surgeon, Raymond Douglas, MD, PhD, has the expertise you can trust when it comes to diagnosing and treating the effects of hyperthyroidism on your eyes. Here’s what Dr. Douglas wants his new and existing patients to understand about the effects of thyroid hormones on your eyes and vision.
Can Hyperthyroidism Really Affect Your Vision?
High levels of thyroid hormones result in symptoms of a hypermetabolic state, with a rapid pulse, heavy sweating, and high blood pressure. You could experience hair loss and struggle to regulate your internal temperature.
You might tend to think of thyroid problems in a weight-loss context. However, about 20 million people in the United States suffer from thyroid-related eye problems of some kind.
If Your Thyroid Gland Overproduces
You’re not likely to see effects on your eyes or vision if you have an underproductive thyroid (hypothyroidism). But, if your thyroid gland overproduces, your hyperthyroidism could impact your eyes.
Autoimmune Issues with Your Thyroid and Eyes
Patients with thyroid eye disease suffer from a type of autoimmune disorder. If you have thyroid eye disease, your immune cells react to your thyroid gland, and often the tissues around your eyes, as well, as they would an attacking foreign body.
Your thyroid responds to your immune system activity by going into high gear, producing higher-than-normal levels of thyroid hormones. During an autoimmune attack related to thyroid eye disease, the muscles and fat around your eyeballs expand, placing potentially dangerous pressure on your eyes. You could also experience redness, swelling, pain, and bulging of your eye area during an attack.
Symptoms Checklist
If you suspect you have thyroid eye disease, use this checklist to see if you might be experiencing symptoms commonly associated with the condition:
- Bulging eyes (proptosis)
- Redness around the eyes
- Swelling of the eyelids
- Pain behind the eyes
- Light sensitivity (photophobia)
- Difficulty moving the eyes or double vision (diplopia)
- Dry, gritty or tearing eyes
- Blurred vision
If you have several of these symptoms, see a specialist to have your condition evaluated and prevent vision loss.
Why Expert Diagnosis Specialized Care Are Recommended for Thyroid Eye Disease
You can protect your eyes from Graves’ eye disease and other potential negative impacts from your thyroid. Get your condition diagnosed by Dr. Douglas’ team of experts, and they can develop the best treatment plan for you. Getting early treatment is important, because as many as 10-20% of patients with thyroid eye disease suffer from vision changes.
Treating your thyroid gland problem alone won’t resolve your Graves’ eye disease symptoms. You may need specialist care to reduce the swelling and relieve pressure around your eye sockets. During the active phase of thyroid eye disease, you’ll need careful monitoring to preserve your vision, as well as corrective care after your symptoms resolve.
Dr. Douglas may recommend artificial tears to address your symptoms of eye discomfort. We can also treat acute autoimmune inflammation for a limited time with prednisone and radiation therapy. If needed, Dr. Douglas is highly experienced with orbital decompression surgery to reduce your ocular pressure levels.
Medical and Surgical Treatment for Thyroid Eye Disease
Treatment for thyroid eye disease can be very different from person to person, depending on the severity of your condition and your individual needs. Both medical and surgical options are available and many people benefit from a combination of both. Below are some of the best options out there.
Medical Options
If your thyroid eye disease is active, medical treatments aim to reduce inflammation, manage symptoms and prevent complications:
- Teprotumumab (Tepezza): This FDA-approved medication for thyroid eye disease is a monoclonal antibody that targets the underlying inflammation and swelling. Often prescribed during the active phase of the disease, Tepezza can help improve symptoms and stabilize the condition.
- Corticosteroids: Medications like prednisone can provide short-term relief by reducing inflammation and swelling during acute flare-ups. However, they are not used for long-term management due to side effects.
- Radiation Therapy: In some cases, low dose radiation can be used to reduce inflammation in the tissues around the eyes when other treatments don’t work.
- Immunosuppressive Drugs: These medications calm down the immune system and prevent further tissue damage and progression of the disease.
Surgical Options
Once the active phase of thyroid eye disease has passed, surgery may be needed to address residual effects, improve vision or enhance the appearance and function of the eyes:
- Orbital Decompression Surgery: This procedure creates more space in the eye socket to reduce pressure on the optic nerve and the bulging of the eyes (proptosis). It’s best for people with severe symptoms or vision loss.
- Eyelid Surgery: Surgery to correct droopy or retracted eyelids can improve the function and appearance of the eyes. This is often done after the inflammation has settled.
- Strabismus Surgery: For people with double vision due to misaligned eye muscles, this procedure aligns the eyes to improve visual alignment and function.
- Blepharoplasty: Often considered an aesthetic procedure, blepharoplasty addresses residual swelling, excess skin, or droopy eyelids so patients can feel confident and comfortable after the active phase of thyroid eye disease.
Each of these treatments is customized to the individual. A thorough evaluation by a specialist like Dr. Douglas is necessary to determine the best course of treatment for you. Early intervention and individualized care make a big difference.
Prevention Tips
While thyroid eye disease can’t be prevented, some lifestyle changes and habits may reduce the risk or severity:
- Quit Smoking: Smoking is a major risk factor for thyroid eye disease and worsens symptoms. Quitting smoking can improve outcomes.
- Manage Stress: Chronic stress can trigger autoimmune conditions. Practice stress management techniques like meditation, yoga or deep breathing.
- Get Eye Exams: Early detection of vision or eye changes can get treatment and better outcomes.
- Stable Thyroid Levels: Work with your endocrinologist to get your thyroid hormone levels in the normal range. Consistency in medication and regular blood tests are key.
- Protect Your Eyes: Wear sunglasses to block UV and wind and use artificial tears to keep them moist.
FAQ
1. Can I have thyroid eye disease if I don’t have thyroid problems?
Yes, although rare, thyroid eye disease can occur in people with normal thyroid function or even hypothyroidism. It’s often related to underlying autoimmune activity.
2. How long does thyroid eye disease last?
The disease has an active phase of 6 months to 2 years. After that, symptoms often stabilize or improve.
3. Is thyroid eye disease the same as Graves’ disease?
No, but they are related. Graves’ disease affects the thyroid gland, and thyroid eye disease affects the eyes. Many people with Graves’ disease develop thyroid eye disease.
4. Can thyroid eye disease cause permanent vision loss?
In severe cases, untreated thyroid eye disease can cause vision loss from pressure on the optic nerve or corneal damage. Early treatment is key to preventing complications.
5. Are there nonsurgical ways to fix bulging eyes?
Medications like Tepezza can reduce inflammation and swelling and improve eye appearance without surgery. But surgery may be needed for significant bulging.
Book a Consultation with Thyroid Eye Disease Specialist Dr. Raymond Douglas Today
To consult with Dr. Douglas about your eye discomfort, bulging eyes, or thyroid eye disease concerns, get in touch with our office in Beverly Hills, Los Angeles, California. Just call us to schedule your appointment.