Because thyroid disease is an autoimmune disorder, your body's immune response can affect the muscles and connective tissue surrounding your eyes. The same antibody that attacks your thyroid gland causing it to malfunction and produce too much or too little thyroid hormone can attack the tissue around the eye.
Since eye problems can continue even after the problem with your thyroid gland has been successfully treated, it's important to see an optometrist or ophthalmologist for evaluation and any eye treatment that may be necessary.
Although the severity of symptoms varies among individuals, disabling vision problems typically occur in people older than age 40. Not everyone with thyroid disease suffers eye-related problems, but sometimes eye or vision problems are the first symptoms of thyroid disease to appear.
Symptoms of thyroid eye disease include:
Red, irritated eyes
Watery or dry eyes
Difficulty closing your eyes
Increased sensitivity to light
Abnormal color vision
What Causes Symptoms
During the inflammatory stage of thyroid eye disease, the eye may be pushed forward and the eyelids pulled open by the muscles around the eyes. As a result, it can be hard to close your eyelids.
What is referred to as "thyroid stare" is the result of tightening of the muscles in the eyelids. This tightening pulls on the eyelids so that more of the whites of your eyes show.
Swelling of the eyelids and swelling in the eye muscles that control eye movement also can occur, the latter causing double vision. While shortening of the eye muscles may occur over time, eye muscles enlarged from swelling can cause bulging or abnormal protrusion of the eyeball.
Corneal ulcer. Severely dry eyes caused by underlying immune system disorders can lead to corneal ulcers. The inability to close the eyelid completely can dry the cornea, making it more prone to ulcers.
Symptoms of a corneal ulcer include redness, pus draining from the eye, eye pain, and impaired vision. A corneal ulcer causes scarring, and if left untreated, can lead to permanent vision loss.
Optic neuropathy. When you have thyroid eye disease, eye tissue swollen from inflammation can compress the optic nerve, which carries messages between the eye and brain. Often, the symptoms of dim vision and reduced visual acuity can be reversed with treatment, but sometimes the condition may progress to permanent vision loss.
Treatment for thyroid eye disease depends on the symptoms, level of severity, presence of scarring, and whether the optic nerve is involved.
1. Eye drops
Your eye care professional may recommend the use of eye drops (artificial tears) and ointments to lubricate dry eyes or ease the irritation that inflamed lacrimal (tear) glands can cause.
Low doses of anti-inflammatory medications, such as corticosteroids, may be necessary if your eye symptoms continue to progress. Once your symptoms are controlled and your eye doctor stops oral steroid treatment, ocular symptoms can reoccur. Your ophthalmologist may then prescribe steroid therapy at a higher dose.
3. Radiation therapy
If you eventually develop an intolerance to steroid medications, your eye doctor may suggest radiation therapy to treat the symptoms of swelling and double vision. Treatment is directed at the eye muscles and is intended to reverse or stop the progress of thyroid eye disease.
Sometimes a symptom, such as puffy eyelids, requires surgery to make the eyelids look more normal again. Vision problems caused by eye muscles that have increased in size can be improved surgically as well. Surgery may be required to reduce eyelid retraction, correct double vision, move eye muscles, or return the eye to a normal position within the eye socket.
For vision services, contact an office such as Cripe Stephens & Stickel.