Graves’ disease is a disorder that causes your thyroid gland to make too much of certain hormones -- a condition called hyperthyroidism. In addition to weight loss, a fast heartbeat, high blood pressure, and irritability, among other symptoms, it also can cause your immune system to mistakenly attack healthy cells. In some people, the muscles and tissue around the eyes are targeted.
About half of people with Graves' disease notice some eye issues, and some have severe vision problems. Experts think this happens because the tissues in your eyes have proteins like ones in your thyroid gland. The problem is known as Graves' eye disease or Graves' ophthalmopathy.
Doctors don't think it can be prevented, but you're more likely to get it -- and have a worse case of it -- if you smoke.
Graves' ophthalmopathy can cause a wide range of issues with your eyes. Some people might have a little redness and minor pain, while others have strong swelling, dryness, and more severe pain. It’s also possible to have bulging eyes -- because your muscles swell and your eyes are pushed out -- and pressure may build up in your eye socket. In rare cases, you can have double vision or other problems with your sight.
Most people with the condition notice eye symptoms within 6 months (before or after) of being diagnosed with hyperthyroidism. People who have severe hyperthyroidism aren't necessarily more likely to have eye trouble than those who have milder cases.
If you think you may be developing Graves' ophthalmopathy, you may need to see both an endocrinologist (a doctor who specializes in problems with hormones) and an ophthalmologist (eye doctor). If you know you have Graves', your doctor should be able to find out if you have the eye problem with a standard eye exam.
In some cases, you may need blood tests, or imaging tests like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan. With a CT scan, X-rays are taken from different angles and put together to make a more complete picture. And an MRI uses powerful magnets and radio waves to make detailed images.
A number of things can help: Artificial tears, gels, and ointments can go a long way toward easing dryness. If you have a lot of swelling -- especially if it leads to double vision or loss of vision -- you might need to take a steroid called prednisone for a few weeks to bring the swelling down. In the rare cases when these don’t work, your doctor might recommend surgery to remove some tissue from your eye socket or radiation therapy, where high-energy X-rays are aimed at the eye muscle.
Graves' ophthalmopathy tends to get better after a few years, but you may have eye problems that need to be corrected with surgery. For example, you might need surgery to ease pain and pressure on your optic nerve, fix the alignment of your eye muscles, or make sure your eyelids cover and protect your eyes.