Thyroid Eye Disease: 7 Symptoms to Look out for

  • Graves’ disease is a condition where the immune system attacks the thyroid gland, resulting in an overactive thyroid gland.
  • Symptoms of the disease are often overlooked because they tend to be similar to symptoms of other common conditions.
  • See your ophthalmologist immediately if you experience symptoms like reddened eyes, dry eyes, bulging eyes, and other changes in the eyes’ appearance.

Graves’ disease is an autoimmune condition in which immune cells attack the thyroid gland, causing it to secrete an excess amount of thyroid hormones. As a result, the thyroid becomes overactive (hyperthyroidism) and metabolism is increased by the excess hormones, according to the American Thyroid Association.

In people with Graves’ disease, the immune system attacks the tissues around the eyes, resulting in thyroid eye disease (or TED), says TED specialist Dr. Andrea Kossler, FACS, of Stanford University Medical Center in Palo Alto, California. Graves’ disease and thyroid eye disease often occur at the same time, affecting the same person.

Because thyroid hormones affect many body systems, signs and symptoms of Graves’ disease can be wide-ranging, or similar to symptoms of other common conditions. For this reason, it may be difficult to diagnose the condition and patients may be treated for other conditions before a proper diagnosis is made.

Below are seven symptoms of thyroid eye disease that you should know about. If you think you have the condition, see your doctor. 

1. Redness of the lids and eyes

One common symptom of mild thyroid eye disease is redness in the conjunctiva, or the white part of the eye which is caused by inflammation, says Dr. Madina Falcone, director of oculoplastics and orbital surgery at the University of Connecticut Health in Farmington.

However, many other conditions including eye infections can also cause redness, which is why thyroid eye disease can be overlooked. “Patients are commonly told that they have an allergy or this is just a symptom of aging. This can be very frustrating for patients to hear,” says Dr. Falcone.

2. Grittiness or excessive dryness in the eyes

Dry eyes or having a gritty sensation in the eyes caused by inflammation is another symptom. This is often treated with artificial tears to restore lubrication, says Kossler.

3. Swelling or puffiness

Inflammation also causes swelling or feeling of fullness in upper or lower eyelids, which can be treated with steroids. However, steroids may no longer be effective if the disease has progressed to more severe symptoms.

4. Proptosis (bulging eyes)

Brown Human Eye

Also called protruding or bulging eyeballs, this occurs when inflammatory cells in the orbit (bony cavity in the skull that houses the globe of the eye) are triggered, causing orbital tissue to expand, says Falcone.

“The muscles that surround and move the eye enlarge, and the fat that surrounds and cushions the eye also thickens. As the entire area gets bigger and bulkier, the eyeballs will begin to bulge forward,” she explains.

Although treatments in the past involved steroids for the redness and swelling, it didn’t affect the position of the eye, she adds.

5. The “thyroid stare”

Human Eye

Thyroid eye disease can cause a person’s eyeballs to push forward with their eyelids pushed back and muscles that open and close the eyelids also become swollen. This results in the so-called ‘thyroid stare’ where patients look like they’re staring. Most people who have this have difficulty closing their eyes, says Falcone.

6. Diplopia (double vision)

Diplopia, or seeing two images of the same thing, is one severe symptom of Graves’ disease. Kossler says this is caused by the muscles around the eyes not functioning properly, causing the eyes to bulge.

While milder symptoms such as flares, or redness and grittiness go away, Falcone says, “Once they start to notice symptoms like bulging and decreased vision, these symptoms don’t resolve without treatment.”

7. Vision loss

Black Framed Sunglasses on White Braille Paper

Caused by the most severe form of thyroid eye disease, vision loss occurs when the optic nerve becomes compressed, says Kossler.


Source: Everyday Health

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