Graves' disease can be behind eye irritations

On Call

March 12, 1996|By Dr. Simeon Margolis | Dr. Simeon Margolis,SPECIAL TO THE SUN

I recently developed Graves' disease and have been having problems with my eyes. They seem to "bulge," and are quite irritated and puffy. What causes these symptoms? Will they go away once my thyroid is treated? What can be done for my eyes?

In Graves' disease, a common disorder, the thyroid gland enlarges and produces too much thyroid hormone, a condition called hyperthyroidism. With it comes anxiety and restlessness; palpitations; weight loss despite an increased appetite and food intake; excessive sweating and intolerance to heat; tremors of the fingers; fatigue and muscle weakness; and diarrhea or an increased number of bowel movements.

Some, but by no means all, patients with Graves' disease also develop mild puffiness around the eyes, a feeling of grittiness or irritation, sensitivity to bright light and a prominent "staring" appearance, due to an upward retraction of the upper eyelids or an actual protrusion of the eyeballs.

We do not know why only some patients with Graves' disease have eye problems while others do not, nor do we know what causes these in the first place. We do know that smokers with Graves' disease are more likely than nonsmokers to develop eye symptoms, so anyone who develops Graves' disease should quit smoking. The eye problems are not related to the severity of the underlying thyroid disorder, and, unfortunately, treating the hyperthyroidism may not help.

Most Graves' disease eye symptoms are so mild that treatment is not needed. Both eye irritation and redness are helped with lubricating eye drops and eye ointments. Dark glasses are also recommended in bright sunlight. Eye problems often resolve on their own over one to three years, without any other treatment.

If your eye problems are more severe, you should consult with an ophthalmologist with an interest in thyroid eye disease. Sometimes it is necessary to use steroids (cortisone) to lessen the swelling and inflammation around the eyes, and very rarely are other treatments needed, such as radiation therapy and surgery. In virtually every case, treatment will improve the situation remarkably.

For more information on the thyroid, write to the Thyroid Foundation of Maryland at 2401 West Belvedere Ave., Baltimore, 21215.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

Pub Date: 3/12/96

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