Graves’ ophthalmopathy is an inflammatory eye disease often seen in hyperthyroidism patients. Symptoms range from redness to bulging eyes. Treatments include ice, medication, and surgery. The autoimmune reaction causing Graves’ disease is still present even if hyperthyroidism is resolved.
Graves’ ophthalmopathy is an inflammatory eye disease usually seen in patients with hyperthyroidism, in which the thyroid gland is overactive. Patients with Graves’ ophthalmopathy may experience symptoms ranging from redness around the eyes to bulging eyes. Treatments can include ice, medications, and sometimes surgery. An ophthalmologist usually supervises the care of this condition and will monitor the patient for signs of increasing severity and complications.
Patients with Graves’ ophthalmopathy usually have a specific thyroid condition called Graves’ disease. Graves’ disease is an autoimmune disease caused by misdirected immune attacks on thyroid tissue. The immune system identifies a protein on thyroid cells as foreign and reacts to those cells, causing swelling and inflammation. The same protein is found in the eye muscles, and many patients with Graves’ disease experience mild eye irritation due to low-level inflammation. Patients with severe Graves’ ophthalmopathy experience bulging eyes as irritated muscles push the eye out of position.
Conservative treatments for Graves’ ophthalmopathy may include elevating the head at night to reduce swelling, using ice packs to address inflammation, and applying lubricating eye drops to address dry eye and ache. Anti-inflammatory medications may also be helpful in reducing swelling and making the eye more comfortable in the socket. In severe cases, surgery may be needed to reshape the socket to accommodate the swelling after other treatments have failed.
Patients with hyperthyroidism, especially Graves’ hyperthyroidism, should be alert for eye pain and irritation. Vision changes are also a cause for concern, as they can reflect damage to the eye muscles, making it more difficult to track images or focus. Symptoms such as redness, swelling, watery eyes, and itching are all warning signs of Graves’ ophthalmopathy. This condition can stabilize and resolve on its own, but this is not always the case. Accessing treatment earlier can reduce the risk of complications, such as pushing the eye out of its socket.
Treating the underlying hyperthyroidism will not necessarily resolve Graves’ ophthalmopathy. The autoimmune reaction is still present and while the thyroid hormones may return to normal, the immune system will continue to attack the eye muscles. People with a history of Graves’ disease who develop eye irritation should tell their doctors about their medical history, as this can be very relevant to diagnosis and treatment. Following guidelines for regular eye exams will help patients identify problems like glaucoma, allergies, and vision changes earlier, when they’re easier to treat.
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