Graves Disease / Thyroid Eye Disease

Thyroid Eye Disease

Thyroid Eye Disease (TED) affects all aspects of the tissue surrounding the eye. It is highly variable, and some patients may have some of the following issues or none at all. It can change the tear gland, the eye muscles, the eye socket, and also the eyelids. Women are much more likely to develop these eye changes than men. Older and Caucasian patients tend to more commonly affected as well. Patients may develop TED even with controlled thyroid function. In some cases, radioactive iodine used to treat the condition may stimulate orbital inflammation.

Dr. Agarwal is an expert in the treatment and surgical management of all aspects of thyroid eye disease. She conducts the examination and surgeries of these conditions, without the need to refer to different doctors as the symptoms change. The signs and symptoms frequently vary, and Dr. Agarwal can see the patient through all questions and treatments from start to finish. She is an expert in surgery of the eyelid, eye muscle, and optic nerve.

The inflammation of the eyelid can cause the eyelid to tether or retract away from the eye, giving the appearance of being startled. With the tethering, eyelids may not close completely while sleeping. Eye lubricants may be helpful to stop the dryness or sandy feeling in the eye. Also, small outpatient eyelid
surgery may be done to relax the eyelids and allow them to open and close easier. As the surgery is done to maintain the health of the eye, these surgeries are usually covered by most insurances.

In the eye muscle changes in TED, the muscles become thickened and inflamed and have difficulty moving the eye. As a result, the eyes may become misaligned and stop moving together. Patients often complain of double vision. Treatment options include subtle patching of one eye, and prism placement
in glasses to align the eyes. If the symptoms persist, once the inflammation stabilizes, small outpatient surgery can be done to decrease the amount of double vision by relaxing the attachments of the eye muscles on the eyeballs.

In rare cases, if muscles become extremely swollen, the optic nerve can be compressed, leading to vision changes. When muscles become swollen or eyes become bulging, orbital decompression can be performed. In this outpatient procedure, openings are made in the walls of the eye socket, relieving pressure on the eye and allowing the inflamed muscles and tissues to relax in these extra spaces.

Graves Disease

Graves’ Disease is an autoimmune condition in which the body’s own immune system attacks the thyroid gland, which primarily controls the body’s metabolic rate. The attack results in an acceleration of the body’s metabolism.

Symptoms include weight loss, irregular heartbeat, irritability, shaky hands, hair loss, skin changes, and eye changes. The eye changes may involve the eyelid, eye muscles, and optic nerve. Please see “thyroid eye disease.”

Like many autoimmune diseases, it affects young women most frequently. However, Dr. Agarwal has diagnosed male and female patients of all ethnicities and ages. The disease is worsened by smoking, stress, and fatigue.

Although there is no cure, symptoms may be treated and the condition improved by certain medications. Furthermore, your thyroid may need to be surgically removed or medically treated to “brake” or decelerate the thyroid gland.