The Bulging Eyes of Graves’ Ophthalmopathy

You may have heard of Graves’ disease. Named for Robert Graves, who first described the condition in Ireland in 1835, Graves’ disease is an autoimmune system disorder that results in an overproduction of thyroid hormones. This hyperthyroidism can affect many different body systems. At the Central Valley Eye Medical, we diagnose and treat a specific area of Graves’ disease known as Graves’ ophthalmopathy that affects the eyes.

What is Graves’ ophthalmopathy?

In Graves’ ophthalmopathy the tissues and muscles behind the eyes become swollen. This swelling makes the eyeballs protrude forward beyond the normal range. This may or may not occur with other symptoms of hyperthyroidism.

What are the symptoms of Graves’ ophthalmopathy?

When a person has Graves’ ophthalmopathy, they will develop one or more of these symptoms:

  • Bug eyes
  • A staring look
  • Dry, itchy, irritated eyes
  • A gritty sensation in the eyes
  • Sensitivity to light
  • Watery, teary eyes
  • A feeling of pain or pressure around the eyes
  • Difficulty fully closing the eyelids
  • Double vision, especially when looking to the side

How is Graves’ ophthalmopathy diagnosed?

When determining if you have Graves’ ophthalmopathy, the team at Central Valley will examine your eyes checking for irritation and protrusion. We’ll check if your thyroid gland feels enlarged. A blood sample will determine your levels of thyroid-stimulating hormone and the levels of thyroid hormones. If we need confirmation, we may order imaging tests such as CT scans or MRIs.

What are the treatment options?

Mild symptoms such as eye irritation may be managed with artificial tears during the day and lubricating gels at night. Often these minor symptoms can resolve themselves in one to four months.

For more severe symptoms, we may use these treatments:

  • Corticosteroids — Prescription corticosteroids, such as prednisone, can diminish swelling behind the eyeballs.
  • Prisms — Prisms in eyeglasses can correct the double vision that is occurring due to the disease.
  • Orbital decompression surgery — If increasing pressure on the optic nerve threatens the loss of vision, we may opt to remove the bone between your eye socket and your sinuses. This gives your eyes room to move back to their original position deeper in the face.

Do you have symptoms of Graves’ ophthalmopathy? Call the team at Central Valley Eye Medical Group, (800) 244-9907, and let’s check your eyes.

Posted in: Thyroid Eye Disease


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