Hyperthyroidism, an overactive thyroid gland, can manifest in various ways, one of which is through eye-related symptoms. Recognizing these crucial indicators of thyroid dysfunction and their associated treatment options can help sufferers manage this condition from the onset and help improve their overall quality of life for years to come.
6 Eye Signs of Hyperthyroidism (and Available Treatment Options For Each)
Bulging Eyes (Proptosis): Also known as exophthalmos, bulging eyes are a hallmark sign of Graves’ eye disease, the most common cause of hyperthyroid-related eye problems. Proptosis occurs when the tissues and muscles behind the eyes swell, pushing the eyes forward. This can lead to discomfort, double vision, and difficulty closing the eyes properly, making individuals more susceptible to eye infections and dryness.
Treatment Options
- Steroids: Oral or intravenous steroids can help reduce inflammation and swelling behind the eyes, alleviating proptosis.
- Orbital Decompression Surgery: In severe cases, surgical decompression may be necessary to create more space behind the eyes, reducing pressure and improving eye appearance and function.
Eye Redness and Irritation: Hyperthyroidism can cause inflammation of the eyes’ surface and surrounding tissues, leading to redness, itching, burning sensations, and excessive tearing. This discomfort can significantly impact daily activities and overall well-being.
Treatment Options
- Lubricating Eye Drops: Artificial tears can provide relief from dryness and irritation by supplementing the eyes’ natural moisture.
- Topical Steroids: Corticosteroid eye drops or ointments may be prescribed to reduce inflammation and alleviate symptoms.
Lid Retraction and Lagophthalmos: Lid retraction refers to the upper eyelids being pulled upward, exposing more of the eyes’ surface. Lagophthalmos occurs when the eyelids do not fully close during blinking, leaving a portion of the eye exposed. Both conditions can lead to dryness, irritation, and increased risk of corneal damage and infection.
Treatment Options
- Moisturizing Eye Gels: Thicker eye gels or ointments can help protect the eyes and retain moisture, especially during sleep when blinking is reduced.
- Eyelid Taping or Shields: These techniques can help support eyelid closure and prevent exposure-related complications.
Double Vision (Diplopia): Due to muscle imbalance and swelling around the eyes, individuals with hyperthyroidism may experience double vision, where they see two images of a single object. This can impair depth perception and coordination, affecting activities like driving and reading.
Treatment Options
- Prism Lenses: Specialized glasses with prism lenses can help align images and reduce double vision by redirecting light rays.
- Eye Muscle Surgery: In cases where muscle imbalance is severe, surgery to adjust the positioning of the eye muscles may be recommended to restore single vision.
Optic Nerve Compression: In rare instances, severe proptosis and orbital swelling can compress the optic nerve, the main nerve responsible for transmitting visual information to the brain. Optic nerve compression can lead to vision loss and other serious complications if left untreated.
Treatment Options
- High-Dose Steroids: Intravenous administration of high-dose steroids may be necessary to rapidly reduce inflammation and alleviate pressure on the optic nerve.
- Emergency Decompression Surgery: Urgent surgical intervention may be required to relieve pressure on the optic nerve and prevent permanent vision loss.
Thyroid Eye Disease (TED) Management: Thyroid eye disease (TED), also known as Graves’ orbitopathy or ophthalmopathy, encompasses a spectrum of eye-related manifestations associated with hyperthyroidism. Recent advancements in TED treatment have expanded therapeutic options for patients, offering more targeted and effective interventions.
New Treatment Options
- Biologic Therapies: Monoclonal antibodies targeting specific immune pathways involved in TED, such as Teprotumumab, have shown promising results in reducing inflammation and improving eye symptoms.
- Radiation Therapy: External beam radiation therapy can help shrink swollen orbital tissues and alleviate proptosis and double vision in TED patients.
- Orbital Radiotherapy: Low-dose orbital radiotherapy can modulate the immune response and reduce inflammation in TED, particularly in cases resistant to other treatments.
Eye signs of hyperthyroidism, particularly those associated with thyroid eye diseases like Graves’ orbitopathy, can have profound effects on an individual’s vision, comfort, and overall quality of life. Early recognition and management of these symptoms are crucial in preventing complications and preserving visual function.
With advancements in treatment options, including novel biologic therapies and targeted interventions, patients with thyroid-related eye problems have more hope for effective symptom relief and improved outcomes. If you’re experiencing any eye-related symptoms associated with hyperthyroidism, consult with your healthcare provider for proper evaluation and management.