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Affected individuals may also experience dry eyes, puffy eyelids, eyelid retraction, inflammation, redness, pain, and irritation of the eyes. Some individuals describe a gritty sensation in the eyes.

This condition is characterized by the development of thickened, reddish skin on the front of shins. It is usually limited to the shins but, sometimes, may also occur on the feet. Rarely, soft-tissue swelling of the hands and clubbing of the fingers and toes acropachy. Males may experience erectile dysfunction.

Thyroid Eye Disease (TED or Graves Eye Disease)

The immune system normally produces specialized proteins call antibodies. Antibodies react against foreign materials e. Antibodies can directly kill microorganisms or coat them so they are more easily destroyed by white blood cells. Specific antibodies are created in response to specific materials or substances. A substance that stimulates an antibody to be produced is called an antigen. This antibody mimics the function of normal thyroid-stimulating hormone.

It attaches to the surface of thyroid cells and turns on the cells to produce thyroid hormones, leading to overproduction of these hormones overactive thyroid. The Tg gene produces thyroglobulin a protein that is found only in thyroid tissue and plays a role in the production of thyroid hormones.

The TSHR gene produces a protein that is a receptor and binds to thyroid stimulating hormone. The disorder usually develops during middle age with a peak incidence of , but can also affect children, adolescents and the elderly. Some relatives may have had hyperthyroidism or an underactive thyroid; others may have other autoimmune diseases including premature graying of the hair beginning in their 20s. Similarly, there may be a history of related immune problems in the family, including juvenile diabetes, pernicious anemia due to lack of vitamin B12 or painless white patches on the skin known as vitiligo.

Thyroid eye disease | You and Your Hormones from the Society for Endocrinology

It is characterized by an enlarged thyroid gland that is infiltrated with lymphocytes. Eventually, the thyroid may be completely destroyed. Treatment consists of replacing the amount of hormone that your own thyroid can no longer make with L-thyroxine, the synthetic form of the major thyroid hormone produced by the thyroid gland. Other causes of hyperthyroidism include a toxic nodular or multinodular goiter, which is characterized by one or more nodules or lumps in the thyroid that gradually grow and increase their activity so that the total output of thyroid hormone into the blood is greater than normal.

Also, people may temporarily have symptoms of hyperthyroidism if they have a condition called thyroiditis. This condition is caused by a problem with the immune system or a viral infection that causes the gland to leak stored thyroid hormone. Types of thyroiditis include subacute thyroiditis, silent thyroiditis, infectious thyroiditis, radiation-induced thyroiditis and postpartum thyroiditis.

Most of the time, the thyroiditis resolves. Finally, hyperthyroid symptoms can also be caused by taking too much thyroid hormone in tablet form. The specific form of treatment recommended may be based upon the age of an affected individual and the degree of the illness. These drugs are especially preferred for the treatment of young children and pregnant women, individuals with mild cases of hyperthyroidism, or individuals in whom prompt control of hyperthyroidism is required.

Iodine is a chemical element used by the thyroid gland to create synthesize thyroid hormones. Affected individuals will swallow a solution containing radioactive iodine, which will travel through the bloodstream and collect in the thyroid gland where it will damage and destroy thyroid tissue. This will shrink the thyroid and reduce the overproduction thyroid hormones.

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If thyroid hormone levels fall too low, hormone therapy to regain adequate levels of thyroid hormone may be necessary. The other definitive therapy is surgery to remove all or part of the thyroid gland thyroidectomy. Hypothyroidism is common after surgery; indeed, this may be the desired outcome. In addition to the three above-mentioned treatments, drugs that block thyroid hormone that is already circulating in the blood from performing its functions beta blockers may be prescribed.

Beta blockers such as propranolol, atenolol, or metoprolol can be used. When thyroid hormone levels return to normal, therapy with beta blockers can be stopped. Lifelong follow up and laboratory studies are necessary in many cases.

Hyperthyroidism and Graves’ Disease

In some cases, lifelong hormone replacement therapy may be necessary. Orbital decompression surgery and orbital radiotherapy may also be necessary in more severe cases. During orbital decompression surgery, a surgeon takes out the bone between the eye socket orbit and the sinuses. This allows the eye to fall back into its natural position within the eye socket.


This surgery is generally reserved for individuals who are at risk of vision loss due to pressure on the optic nerve or in whom other treatment options have not worked. Information on current clinical trials is posted on the Internet at www. Thyroid eye disease can cause inflammation that may affect the muscles and other tissues around the eyes.

Symptoms often include the following:. It often lasts one to two years. When it has been inactive for a period of around a half a year, it's less likely to recur. Thyroid eye disease is an autoimmune eye condition that, while separate from thyroid disease, is often seen in conjunction with Graves' disease.

About 25 to 30 percent of people with Graves' disease have a mild form while only a tiny percentage develop a severe form. The condition, however, is seen in people with no other evidence of thyroid dysfunction, and occasionally in patients who have Hashimoto 's disease.

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Most thyroid patients, however, will not develop thyroid eye disease, and if so, only mildly. Smoking is associated with a worsening of symptoms. If you have hyperthyroidism and begin to experience symptoms involving your eyes, you should have a complete eye exam by an ophthalmologist. If you have never had issues with your thyroid, a simple blood test will be ordered to check your thyroid levels.

Your doctor may find swelling and enlargement of the eye muscles.

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A CT scan or MRI scan of the eyes may be used to examine any swelling of the tissues behind the eye, in order to confirm the diagnosis. For a mild case, instill lubricating eye drops and artificial tears a few times during the day. Avoid wind and bright light. If you have severe symptoms, your doctor may prescribe corticosteroids such as prednisone to reduce swelling. In a very small percentage of patients, orbital decompression surgery may be recommended.

This procedure removes the bone between the eye socket and the air sinus behind it so your eye has more room. This can improve your vision but there is a risk of double vision.

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Double vision can also occur when scar tissue from the ophthalmopathy makes an eye muscle too short. Eye muscle surgery can be used to attach the muscle at a point where it will again be the correct length to provide single vision. However, more than one surgery may be needed to be successful. If you are diagnosed with thyroid eye disease, be sure to wear sunglasses while in the sun. Your eyes will be more sensitive to the sun and wind and more vulnerable to ultraviolet rays.

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  4. You may also try elevating the head of your bed to help relieve the pressure and swelling. Cool compresses may also help provide relief. Losing weight with thyroid disease can be a struggle.