The thyroid is a medical condition in which the thyroid gland in your body is not able to sufficiently produce the hormones. If it is producing more hormones than necessary, it is called hyperthyroidism whereas if it is producing less than necessary, it is called hypothyroidism.

However, relating to the thyroid, there is yet another medical condition called thyroid eye disease. In this, the muscles and soft tissues behind your eyes tend to swell up. When they swell up, they tend to push the eyes out which gives you the impression of bulging eyes.

What Exactly Happens in Thyroid Eye Disease?

As mentioned earlier, the muscles and tissues situated behind the eye socket are inflamed and swollen, due to which the eyes tend to bulge out. This happens because there is limited space between the orbit, so as the tissues start to swell, the eye is pushed out. Sometimes it so happens, that the eye is pushed so far out that the eyelids do not close effectively, leaving the eye dried out. Other times, due to strain in the nerve cells connecting the eye and the brain, the eyeball is not able to move properly.   

This situation in medical terminology is also called exophthalmos, thyroid ophthalmopathy, dysthyroid eye disease. More often than not, exophthalmos happens generally when one is suffering from hyperthyroidism. If this situation worsens, it can also affect the vision.

Thyroid eye disease is an autoimmune eye disease in which the immune system creates antibodies to fight against the healthy tissues of the thyroid gland as well as the tissues around the eyeball in the body. In the medical world, people have not been able to figure out why this happens, people’s bodies just tend to develop an autoimmune system.

Who is prone to suffer from Thyroid Eye Disease

Thyroid Eye disease occurs in people who are in the middle-aged groups. It generally occurs when these people are suffering from any kind of hyperthyroidism, that is, their thyroid glands are producing more amounts of hormones or when their thyroid had been functioning abnormally in the past.  Thyroid Eye disease also occurs in people who are heavy smokers or have certain genes in the body that can cause them to develop this situation in the future.

What are the Symptoms of Thyroid Eye Disease

Thyroid eye disease is, more often than not, difficult to diagnose and often mistaken as conjunctivitis, allergy, or even hay fever. However, you need to know for sure that these are the symptoms of a thyroid eye disease when:

• You have bulged out eyes but not itchy or sticky eyes. This happens in allergies and conjunctivitis respectively.
• The symptoms occur in the season in which hay fever should not.
• You feel an ache or pain behind the eyes, especially when you see up or look down, or try to move your head sideways.
• You start to notice double vision. Double vision can only occur when you have a thyroid eye disease and not an allergy, conjunctivitis, or hay fever.

The common symptoms associated with Thyroid Eye Disease are as follows:

• One of the most common thyroid eye diseases is staring or bulging eyes.
• As the eyes are bulged out, there is a feeling of grittiness or excessive dryness that is associated with the eyes.
• You might also experience watery eyes.
• As the tissues push out the eyes, you will experience a severe intolerance towards bright lights.
• There will be a sort of swelling or fullness in the upper or lower eyelids.
• Your face will develop new bags under the eyes.
• Bulging out of the eyes can cause redness and itchiness of the eyes.
• As mentioned earlier, you will also experience blurred or double vision and pain near the eye sockets especially when you try to look upwards, downwards, or sideways.
• You might also face difficulty in moving your eyes due to the pain.

Sometimes, as the thyroid eye disease worsens, its symptoms also significantly worsen. Under such circumstances, you will experience:

• Disabling double vision
• The primary layer of your eye, popularly known as the cornea can develop ulcers, especially when the eyelid is not closed completely. These ulcers can also block your vision and hinder your eyesight as they can compress the optic nerve.

If you are facing any of these symptoms, it is most appropriate to seek medical attention as soon as possible and avoid procrastinating the situation.

How can Thyroid Eye Disease be Treated

If it is just a mild condition, that is, if your eyes feel gritty, or they start watering and turn uncomfortable when bright lights are switched on, artificial tear drops can be a perfect solution for your eyes. Artificial tear drops can provide you with much-needed comfort and also protect the surface of your eyes.

They can be in the form of liquid drops, gels that are slightly thicker than the watery liquid and ointments. Ointments for thyroid eye disease are oily lubricants that last for the longest time possible. However, they can only be used during night time as they can cause blurry vision. It can take a significant time of six or twelve months to finally get rid of the inflammation and for your eyes to turn stable. If it still does not improve, you can also opt for steroids prescribed by your ophthalmologist.

Steroids can help in the reduction of double vision as it relaxes the inflammation in the muscles and supports them to move more freely. Moreover, it can help reduce the swelling and itchiness of the eyes and help improve your eyesight.  

Your doctor might also suggest you combine steroids with other treatments such as immunosuppressive agents and radiotherapy under extreme situations for effective control. Be that as it may, steroids cannot reduce the bulging or the protrusion of the eyes. Under situations where you are left with permanent double vision, your doctor is left with no other choice than to conduct rehabilitative surgery to treat your thyroid eye disease along with:

• Decompression surgery, which involves creating more space behind the eyes. This helps in the complete closure of your eyes which in turn protects them.
• Eye muscle surgery involves treating your double vision especially when it cannot be managed with the help of prisms. Prisms are attached to the spectacles which help in controlling double vision.
• Eyelid surgery helps in shielding your eyes.