1. Bulging Eyes (Graves’ Ophthalmopathy)
- Dry, gritty eyes
- Double vision
- Sensitivity to light
- Pain, pressure, or trouble moving the eyes
- Swelling around the eyes
In severe cases, inflammation can cause pressure on the optic nerve between the eyes and brain, causing vision loss.
Graves’ ophthalmopathy symptoms generally appear within six months of — before or after — a Graves’ disease diagnosis, says Dr. Mikhael. The condition may remain stable, worsen, improve, or come and go. Rarely, the condition appears after Graves’ disease has been treated; it can also occur in people who don’t have hyperthyroidism.
“Treatment of the hyperthyroidism does not improve the underlying inflammation but improves the eye signs related to hyperthyroidism alone like the thyroid stare,” says Mikhael.
After the hyperthyroidism is under control, treatments for Graves’ ophthalmopathy depend on the severity of the disease, based on an evaluation by an ophthalmologist and an endocrinologist, says Mikhael.
In mild cases, your doctor may recommend one or more treatments to address specific symptoms, including:
- Eye drops to soothe eye irritation
- Sunglasses to help ease sensitivity to light
- Special eyeglasses to improve double vision
- Sleeping with your head elevated to reduce swelling around the eyes
- Selenium supplementation has been shown to reduce ocular involvement and slow the progression of the disease in patients with mild Graves’ opthalmopathy
For more severe cases, Mikhael says doctors may prescribe:
- Oral or intravenous corticosteroids
- An immune suppressing medication to quiet your body’s underlying inflammatory response
- Teprotumumab, a disease-modifying intravenous medication for the treatment of active moderate-to-severe Graves’ ophthalmopathy
- Surgery, if pressure on your optic nerve poses a risk of vision loss or severe disease doesn’t respond to other treatments
- Radiation therapy, though this is less commonly used and usually done in conjunction with corticosteroids
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