Overview Of The Connection Between Thyroid And Eyes
The thyroid is a small, butterfly-shaped gland at the base of your neck. As part of the endocrine system, the thyroid gland produces hormones that regulate your body’s energy use, along with many other important functions. When thyroid hormone levels are unbalanced, body processes change, affecting virtually every system in the body.
Researchers don’t quite understand why thyroid disease can affect your eyes. However, since there are thyroid hormone receptors all over our bodies, it stands to reason that thyroid diseases can affect every organ system.
Common eye complaints in hyperthyroidism
Hyperthyroidism is a condition in which the thyroid gland produces too much thyroid hormone. Signs and symptoms vary from person to person but commonly include irritability, sleeping problems, muscle weakness, fast heartbeat, heat intolerance, tremors, or weight loss. Graves’ disease, an autoimmune condition, causes more than half of the cases of hyperthyroidism in the United States.
People with hyperthyroidism can have a variety of concerning eye symptoms, including:
One of the hallmark signs of Graves’ ophthalmopathy is bulging eyes. Not everyone with Graves’ disease will develop this symptom . Still, vision changes can be hard to restore even with treatment.
Common eye complaints in hypothyroidism
Common eye complaints in people with Hashimoto’s include:
How Is Thyroid Eye Disease Diagnosed
Thyroid eye disease is often diagnosed at the same time as Graves disease. The signs and symptoms described above such as red, swollen eyes will prompt the doctor to suspect thyroid eye disease. A simple blood test called thyroid function test will be carried out to measure the levels of thyroid hormones and thyroid stimulating hormone in the bloodstream. In Graves disease, levels of thyroxine and/or triiodothyronine will usually be raised with undetectable levels of thyroid stimulating hormone. Blood tests may also be carried out to detect thyroid antibodies, which would indicate autoimmune thyroid disease.
What Causes Graves Ophthalmopathy
The exact cause of GO isnt clear, but it may be a combination of genetic and environmental factors.
The inflammation around the eye is due to an autoimmune response. With GO, the same abnormal immune response that triggers the thyroid gland in Graves disease affects the muscles and soft tissues around the eye. This leads your body to produce an inflammatory response.
Symptoms develop because of swelling around the eye, forward bulging of the eyes, and retraction of the eyelids.
Graves eye disease usually occurs in conjunction with hyperthyroidism, but not always. It can occur even when your thyroid isnt currently overactive.
Risk factors for GO include:
- genetic influences
- iodine therapy for hyperthyroidism
Women are also at a higher risk of developing GO compared with men.
Theres no way to completely prevent Graves disease or Graves eye disease. But if you have Graves disease and you smoke, youre around 5 times more likely to develop eye disease than people who dont smoke. Plus, eye disease tends to be more severe for those who smoke.
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Can Synthroid Affect Your Vision
Synthroid is one of the most common medications used to treat hypothyroidism. Also known by its generic name levothyroxine, Synthroid contains synthetic thyroid hormone that helps to replace low thyroid hormone in your body.
Like most medications, Synthroid comes with a list of side effects. One of the rarer side effects of Synthroid is that it may cause blurred or double vision and eye pain. These symptoms may stem from swelling caused by taking too much thyroid hormone or an adverse reaction to the medication, like an allergic reaction.
There are very few reports that Synthroid directly causes eye problems, except in rare cases where it is an adverse reaction. If you struggle with eye issues while taking Synthroid, it is more likely related to your thyroid not being correctly managed or other causative factors like allergies, etc.
About Dr Alan Mendelsohn
Dr Alan Mendelsohn is an ophthalmologist in Hollywood, Florida since 1987. He is a pioneer cataract surgeon at Eye Surgeons & Consultants dedicated to increasing the awareness of serious eye issues.
About Dana Trentini
Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. Hypothyroid Mom LLC is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. To keep the website up and running, Hypothyroid Mom LLC includes sponsored guest posts and affiliate links including the Amazon Services LLC Associates Program and Get Healthy by Healthy Life Enterprises, Inc. These statements have not been evaluated by the Food and Drug Administration.
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What Do Your Eyes Look Like When You Have Thyroid Eye Disease
Thyroid eye disease is a condition in which the eye muscles, eyelids, tear glands and fatty tissues behind the eye become inflamed. This can cause the eyes and eyelids to become red, swollen and uncomfortable and the eyes can be pushed forward .
Can thyroid problems affect your eyes?
Eye problems, known as thyroid eye disease or Graves ophthalmopathy, affect around 1 in 3 people with an overactive thyroid caused by Graves disease. Problems can include: eyes feeling dry and gritty. sensitivity to light.
What Are The Potential Complications Of Bulging Eyes
Because bulging eyes can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow your treatment plan. This will help reduce the risk of potential complications.
Complications of bulging eyes vary with the underlying cause. Possible complications include:
Corneal erosion and ulceration from the eyeballs protruding so far that the eyelids cannot completely close. This causes dryness and damage to the cornea.
Swelling and scarring of the tissue around the eye, which can change the way the eyes move and their appearance. Gaze limitation may also cause double vision.
- Vision loss, which may be permanent
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Regular Eye Exams And Thyroid Eye Disease
Getting regular eye exams helps keep your eyes healthy and allows your doctor to spot any eye changes early. Catching a serious condition such as thyroid eye disease early may help mitigate or prevent serious damage that could result in vision loss.
Can Hypothyroidism Cause Under Eye Bags
Hi. I have hypothyroidism and take Synthroid. My levels are ok as per my family physician. However, I hate my malar bags and under eye bags. How can a doctor tell if these conditions are related to hypothyroidism?I am considering plastic surgery and my insurance co requires a letter of medical necessity to cover this. What constitutes medical necessity in this instance? Thank you.Carole
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Thyroid Eye Disease Symptoms
The symptoms of thyroid eye disease may become apparent during the active phase of the disease. Symptoms may include:
In severe cases, patients may have trouble moving their eyes. In a small percentage of cases , patients may experience vision loss due to compression of the optic nerve.
Some patients also experience cosmetic changes around the eyes such as fat deposits or hollow areas that create shadows under the eyes.
What Are The Longer
With the correct treatment, thyroid eye disease can be well managed and patients can live full and active lives. Most of the effects of the thyroid eye disease will settle with time and when thyroid function is stabilised. Patients taking carbimazole tablets to treat hyperthyroidism may need to take them daily for life, although definitive treatment of the overactive thyroid gland with radioiodine or surgery is generally preferred, once the eye disease has settled down. Regular blood tests should be carried out to monitor thyroid hormone levels and the dose of carbimazole adjusted accordingly. However, there are other treatment options such as thyroidectomy or radioiodine treatment that can be considered once the eye disease has settled down.
The changes in the physical appearance of the eyes can have a psychological effect on the individual, causing low self-esteem. The long-term consequences of the disease, even after the thyroid has settled down, may be difficult to accept. Some patients may have a permanent change to their appearance, which may require surgery. Very rarely, there is a permanent loss of vision this can happen if the disease is left untreated at the sight-threatening stage.
Patients should stop smoking as this is known to aggravate the condition. Sunglasses may be necessary even when indoors. If double vision is not corrected, driving will be dangerous. Patients should discuss any concerns with their doctor.
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Webmd: Eyes Bulging Not Feeling Quite Right It Could Be Thyroid Eye Disease
WebMD recently interviewed surgeon Raymond Douglas, MD, PhD, professor of Surgery and director of the Thyroid Eye Disease Program at Cedars-Sinai, about the signs of thyroid eye disease and how to treat it.
Thyroid eye disease is a rare autoimmune condition that causes swelling, inflammation, and damage in the muscles and tissues around the eyes.
Symptoms can include redness, dryness, discomfort, irritation or pain behind the eyes as well as eyelid retraction or bulging eyes. Fortunately, “the majority of cases are mild,” Douglas told WebMD.
The condition often affects people who also have Graves’ disease, which causes the body to make too much thyroid hormone. About 80% of patients with thyroid eye disease have already been diagnosed with Graves’, but some people with the disease dont have a thyroid condition at all, according to Douglas.
People often blame aging or allergies for their eye issues, and their symptoms might be dismissed by their provider as mild allergies, Douglas said. But if patients notice their eyes bulging, or if they experience vision changes or eyelids that won’t close completely, Douglas advised seeing a doctor. “Dont settle for an unsatisfactory answer,” he told WebMD.
Click here to read the complete article from WebMD.
How Is Graves Ophthalmopathy Diagnosed
When you already know you have Graves disease, a doctor can make a diagnosis of GO after examining your eyes. A specialized doctor called an ophthalmologist will help you manage GO, while your primary care doctor or endocrinologist will manage hormone treatment for Graves disease.
If you dont already have a diagnosis of Graves disease, your doctor will likely begin by looking closely at your eyes and checking your neck to see whether your thyroid is enlarged.
Then, your blood can be checked for thyroid stimulating hormone . TSH, a hormone produced in the pituitary gland, stimulates the thyroid to produce hormones. If you have Graves disease, your TSH level will be low, but youll have high levels of thyroid hormones.
Your blood can also be tested for Graves antibodies. This test isnt needed to make the diagnosis, but it may be done anyway. If it turns out to be negative, your doctor can start looking for another diagnosis.
Imaging tests such as ultrasound, CT scan, or MRI might also be done so the doctor can get a detailed look at the thyroid gland.
Your doctor may also want to perform a procedure called radioactive iodine uptake. For this test, youll take some radioactive iodine and allow your body to absorb it. Later, a special scanning camera can help determine how well your thyroid takes in iodine, which helps inform the diagnosis of Graves disease.
There are quite a few things you can try on your own to ease symptoms of GO, including:
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Who Is At Risk For Thyroid Eye Disease
Thyroid eye disease is most commonly associated with Graves disease. It can also occur with normal thyroid hormone levels or low levels of thyroid hormones .
Other risk factors for thyroid eye disease include:
- Age: Usually affects middle-age adults but can occur at any age
- Gender: Females are affected more than males
- Family history of thyroid eye disease
- Smoking: Smoking increases the risk of thyroid eye disease by 78 times, causes thyroid eye disease to have a longer active phase, and it reduces the effectiveness of treatments
- Radioactive iodine therapy: Radioactive iodine has been used to treat hyperthyroidism and Graves disease. This treatment should be used with caution in people with active thyroid eye disease as it may worsen the condition unless steroids are given at the same time
- Low blood levels of selenium, a dietary mineral.
Vision Issues Associated With Hyperthyroidism
Graves’ disease is a leading cause of hyperthyroidism in America as it affects 1 out of every 200 people. In individuals diagnosed with Graves’ Disease, 30% of people may also have thyroid eye disease known as Graves’ Ophthalmology. Mild cases can clear up while treating hyperthyroidism. However, others may lead to severe problems, like vision loss.
Symptoms of Graves Ophthalmopathy include:
- Eyes that feel gritty or dry
Consulting with an ophthalmologist can help diagnose these symptoms as Graves’ Ophthalmopathy or find some other underlying vision problem for which they can help create a treatment plan. Some courses of treatment include eye drops, steroids, or even surgery, depending on the severity of the symptoms. Having the proper treatment plan in place will ensure you address your vision problems with the intensity they need and help prevent the symptoms from worsening and causing long-term damage.
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Other Potential Symptoms Of Thyroid Eye Disease To Look For
TED affects everyone differently. You may experience all or some of the symptoms listed below. After reading about the symptoms of TED, you can use the interactive tool Talking to Your Doctor about TED to help you prepare for your next appointment with your doctor.
Dry, gritty eyes
- Eyes feel dry and gritty
- This may make it feel like theres something in your eye, like sand
Swollen, puffy eyelids
- Eyelids look red and swollen
- Your doctor may call this eyelid edema
Watery, teary eyes
- Eyes are constantly watery, when not crying
- This can make it hard to see clearly because of extra fluid
Red, swollen eyes
- Eyes appear red, bloodshot, and swollen
- Your doctor may call this erythema or chemosis
- This is sometimes confused with allergies or an infection
- Eyes may become sensitive to light
Eye pain or eye pressure
- Pain may be felt in, around, and behind the eyes, and when moving the eyes
- Pressure may be felt behind or around the eyes, which can lead to headaches
- Eyes look crossed or misaligned
- This can lead to double vision
- Your doctor may call this strabismus
- Vision becomes out of focus or blurry
Pulled-back eyelids, also called eyelid retraction
- Eyelids are pulled back
- This may cause a constant stare or wide-eyed appearance
- It may also make it hard to close your eyes
- To sleep, your eyes may need to be taped shut
- This can expose more of the eye than normal which can lead to other symptoms like dry eyes
You May Not Taste Or Smell Things The Same If Youre Hypothyroid
Too little thyroid hormone can cause alterations to how we taste and smell, which will mess with your enjoyment of food big time! Notice your sense of smell has changed? I recommend a full thyroid panel, plus testing for zinc deficiency, which is also a common cause of changes in our ability to smell.
In a 1975 study , it was concluded that change in the sense of smell and taste are common clinical abnormalities of primary hypothyroidism. This is a big reason why hypothyroidism can cause you to become adverse to food and lose your appetite.
Good news! When the hypothyroidism is treated, these senses come back! That makes this little foodie super happy!
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What Causes Puffy Eyes
Puffy eyes usually appear either as a result of the natural ageing process, or due to a build-up of fluid in the thin layers of skin and connective tissue surrounding your eyes. Lifestyle factors, such as how much you sleep and exercise, and what you eat and drink, can have a massive impact on puffiness.
Here are some of the possible causes of puffy eyes, listed:
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Ask Your Doctor If You Should Try A Selenium Supplement
Selenium is a nutrient thats important for normal thyroid hormone production. When people with mild Graves ophthalmopathy took 100 micrograms of selenium twice a day for 6 months, their disease didnt progress as quickly as in those who took a placebo, according to a study published in the New England Journal of Medicine. They also experienced an improvement in their quality of life.
Ilya Leyngold, MD, an ocular plastic surgeon at Duke Eye Center in Durham, North Carolina, cautions that this particular study was performed in Europe, where the soil is not rich in selenium. Americans generally get enough selenium through their diet already, according to the National Institutes of Health Office of Dietary Supplements, so supplementing may not be helpful. Plus, taking too much selenium can increase the risk of skin rashes, diarrhea, and other symptoms, along with increasing the risk of developing type 2 diabetes.
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Drugs For Thyroid Eye Disease
In 2020, the U.S. Food & Drug Administration approved a new drug to treat thyroid eye disease. The drug, Tepezza , may significantly reduce eye-bulging and may improve or eliminate double vision in TED patients.
Doctors also use corticosteroids such as prednisone to reduce the inflammation and swelling caused by moderate to severe thyroid eye disease. However, steroids generally will not reduce eye-bulging or correct double vision.