Thyroid eye diseases (EDT) is a condition of the eye which fatty tissues and eyes muscles inflamed, reddened, and swollen. It causes the eye to be swollen and pushing forward, so eyes become bulging or staring eye. Muscles involved in the movements of the eye are also inflamed and swollen, sometimes, so that they don’t remain in an axis and cause double vision. Thyroid eye diseases can rarely cause blindness due to the pressure on the optic nerve of the eye.
Why thyroid eye diseases occur? It is actually an autoimmune disease in which the body’s immune system starts producing the antibodies against the body’s own cells (cells at the back of the eye) and cause inflammation. In other words, this disease is also known as Graves Disease which is due to the overproduction of thyroid gland or hyperthyroidism.
Classical Symptoms of Thyroid Eye Diseases
When the thyroid gland produces an excess amount of thyroxin under the action of the body’s immune system, therefore, some most common symptoms begin to appear in response to hyperthyroidism. You need to call your doctor if you have any of the following symptoms:
- Dry eye
- Excessive tearing of the eye
- Staring or bulging eyes
- Grittiness sensation in the eyes
- Inflammation of the eye
- Eye bags under the eye
- Insensitivity for bright lights
- Eye Disease that causes Blindness
- Swelling or fullness in one or both the upper eyelids
- Double vision
- Difficulty in eye movements
- Forward bulging of the eye, often called as proptosis
- Pain in the eyes, especially during the eyeball movements
- Sensitivity to light, or photophobia
Sometimes, it is very difficult to diagnose thyroid eye diseases because most of its symptoms are reassembled with conjunctivitis or other eye conditions. But some symptoms are the characteristic of this disease, therefore, other conditions must be ruled out. These characteristic symptoms of thyroid eye diseases are
- Double vision
- Pain in or behind the eyes, during the movements
- Doesn’t depends on the season
- Not have itching eyes, as in conjunctivitis
Causes of Thyroid Eye Diseases
Thyroid eye diseases are mostly autoimmune conditions than other thyroid diseases. It is often conjunct with the graves Eye diseases in which auto-antibodies are formed against the body cells and start producing the excess amount of thyroxin by the thyroid gland.
This thyroxin T3 & T4, boost up body metabolism.
The hypermetabolic the state is characterized by rapid heartbeat, fast pulse, palpitations, high blood pressure profuse sweating, irritability, heat intolerance, weight loss, fatigue, and loss of hairs. In chronic illness, when there is uncontrolled production of thyroxin, Thyroid Storm or thyrotoxicosis occur which is a toxic condition of thyroid eye diseases.
It inflamed the soft tissues and muscles of the eye and may put pressure on the optic nerve. Patients have toxic look such as aggressive, bulging, and red eyes. Smoking aggravates the symptoms and condition of the eye. It can be treated effectively by medically or surgically if it diagnosed early.
Tests and Diagnosis
If the above-mentioned symptoms appear in your body and your doctor suspect hyperthyroidism, the following tests are necessary to confirm the expected diagnosis.
1- Thyroid Function Tests
Serum T3, T4, and TSH levels are evaluated. Their higher amount in blood suggests the over-activity of the thyroid gland. It is a foremost and important test.
When you have known about the overactivity of the thyroid gland, ultrasound or CT scan should be done to localize the affected part. Imaging such as ultrasound, CT scan, MRI suggests about any nodularity and localization of the affected part
3- Thyroid Scan
This is done in an advanced stage when symptoms going to worsened. This scan involves the radioactive element which is swallowed by the patient. The patient is allowed to sit in a darkened, protected room alone, to see the radioactive radiation emit by the patient’s thyroid gland.
4- Tissue Extraction
When there are multiple nodularities, enlarged thyroid gland, toxic eye look, and no improvement, your doctor does an FNAC ( fine needle aspiration cells) to take a sample or thyroid gland and sent it to a laboratory for the further assessment.
These above stepwise tests are more than enough to make a diagnosis about the thyroid eye diseases.
Treatment for Thyroid Eye Diseases
Treatment depends on the eye conditions, disease severity and it’s onset.
For Mild Disease
For mild irritation and gritting sensation, artificial tears are prescribed. Selenium supplements are recommended daily for one dose in mild disease. Along with, referred the patient to an ophthalmologist to check whether you have a thyroid eye disease or other eye condition.
For Severe Disease
In severe uncontrolled thyrotoxicosis, thyroid gland might be removed surgically. In severe eye conditions, eye muscles or soft tissues are surgically corrected. Thyroid supplements are recommended to the patient for the lifetime. Puffiness under the eyes is corrected to have a more good appearance. The patient’s attendants are advised regarding his or her diet. Counseling is also an important part of thyroid treatment. Radiotherapy or chemotherapy can also be done instead of surgery.
Important Preventative Tools
Some important preventive measures should adopt to everyone to avoid the thyroid eye diseases or to prevent the progression of sub-clinical thyroid disease. These easy, but effective preventive measures include
- Ask the patient to quit smoking, as it aggravates the symptoms and worsens the condition.
- Don’t show any carelessness in your daily selenium supplements dose. Six months course of selenium tablets should be done under the proper care.
- Avoid any sudden rise or fall in your thyroxin amount. To avoid this, you must have your regular blood test and follow the advice of your doctor.
- Your diet must have iodized salt in hypothyroidism and must be iodine free in hyperthyroidism state.
- You should have your regular eye checkups to your ophthalmologist to avoid the progression of subclinical eye diseases.
- Stay calm and peaceful to avoid any sympathetic drive.