The thyroid gland is responsible for secreting hormones that control the body’s metabolism. When the thyroid fails to produce enough of these hormones, a condition called hypothyroidism occurs, and it is marked by fatigue, weight gain, constipation, intolerance to cold temperatures and dry skin. An overproduction of these hormones, however, causes hyperthyroidism. Characterized by nervousness, weight loss, shakiness, rapid heartbeat and intolerance to heat, hyperthyroidism can also lead to a condition affecting the eyes called Graves’ eye disease.
What Is Graves’ Eye Disease?
Also called thyroid eye disease, this condition is a combination of thyroid disease and certain eye changes that occur when the immune system attacks the thyroid gland and tissues around the eyes. The most telling sign of Graves’ disease is a protrusion of the eyeballs. Other symptoms can include swollen eyelids and eye redness, burning and watering. As the disease progresses, some people have trouble closing their eyelids all the way or develop double vision. Over time, the eye bulging, also called proptosis, can progress to a point where the cornea is exposed and develops ulcers and infections. In extreme cases, the optic nerve may experience strangulation, which leads to impaired vision.
Who Gets Thyroid Eye Disease?
As with all autoimmune diseases, the cause of Graves’ disease is unknown. Women are 10 times more likely to develop the condition than men, and people with a family history of the condition are thought to be at an increased risk. Those who already have an autoimmune disease, such as rheumatoid arthritis or lupus, are also more likely to develop thyroid eye disease. Although anyone at any age can be struck with Graves’ disease, it most often begins in a person’s 20s or 30s.
How Is the Condition Diagnosed?
Physicians in Houston are most often prompted to investigate the possibility of thyroid eye disease when they see the characteristic eye bulging in a patient. Blood tests can confirm abnormal thyroid levels and detect antibodies that may point to Graves’ disease. Imaging tests, including MRIs and CT scans, can also reveal swelling or other abnormalities in the eyes and orbits that suggest thyroid eye disease.
What Are the Treatment Options for Graves’ Eye Disease?
Graves’ disease manifests in two phases. Phase one is called the active phase, and this is when the inflammatory symptoms occur. During this phase, which can last anywhere from a few months to two years before spontaneously halting, the goal of treatment is to manage symptoms. Corneal exposure, which leads to dry eyes and ulcers of the cornea, can be addressed with artificial tears, and some patients tape their eyelids shut at night to avoid further exposure. Corneal ulcers may also require frequent rounds of antibiotics to prevent complications. When strangulation of the optic nerve occurs, radiation therapy can help reduce inflammation in the orbital tissue. Radiation is sometimes combined with steroids that are administered either orally or via injections in the eye orbit. While steroids can effectively suppress inflammation, these medications can cause side effects and are not a safe long-term solution.
The second phase begins when the inflammation subsides and the disease stabilizes. At this point, a Houston Graves’ disease repair & reconstruction physician can perform one or more surgical procedures to correct tissue changes. The surgeon can correct double vision with a procedure that repositions the eye muscles. An oculoplastic surgeon may also perform orbital decompression surgery to create more room in the eye socket. This surgery relieves pressure on the optic nerve to preserve vision and gives bulging eyes adequate room to return to their normal positions. After the orbital decompression procedure, a Houston eyelid surgery specialist can correct eyelid retraction with surgical repositioning or by weakening the muscles of the upper eyelids so that they droop and provide more cover for the eyes.