Graves’ disease is a thyroid disorder in which the thyroid gland, which produces hormones in response to foreign invaders such as viruses or bacteria, is overactive, causing a number of physical reactions. These include weight loss, rapid heart rate, sweating, and changes to bone, skin, and nails^1^.
The eyes are affected through a separate, yet related disease called Graves’ ophthalmopathy. In Graves’ ophthalmopathy, the overactive thyroid targets the area surrounding the eyes and may cause inflammation, redness, achiness, pink eye, eyelid retraction and bulging eyes^2^.
Although Graves’ ophthalmopathy is caused by a hyperactive thyroid, the hormones that affect the eyes are not the same ones that cause reactions in other parts of the body. In roughly 10% of cases, people with Graves’ ophthalmopathy do not actually have Graves’ disease^3^.
In extreme cases of Graves’ ophthalmopathy, swollen eye muscles may put extreme pressure on the optic nerve, leading to double vision^4^.
Graves’ ophthalmopathy is an autoimmune condition where the thyroid gland mistakenly senses harmful cells and releases antibodies to combat them^3^. Since there are no harmful cells, the released antibodies end up fusing with muscles in the eyes, causing the onset of Graves’ ophthalmopathy.
An eye care professional can determine the presence of Graves’ ophthalmopathy by carrying out a thyroid function test after observing common symptoms.
The commonest symptoms of Graves’ ophthalmopathy are associated with inflammation, swelling and redness of the eyes. Symptoms vary from person to person and can include^4^:
Symptoms of Graves’ ophthalmopathy may clear without intervention within a year. Many patients will need to continue treatment to regulate the overactive thyroid and/or continue with symptom-based treatments. These may include:
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