Graves' eye disease

Graves' eye disease is an eye condition where swelling occurs around the eyes, making them bulge out. Graves' disease is also knowns as Graves' ophthalmopathy, GED or thyroid eye disease (TED).

This condition is usually mild and resolves on its own. It doesn't cause vision loss, but double vision and other symptoms may occur. Treatments are available for these symptoms.

What is Graves' disease?

Graves' disease is an autoimmune disease that occurs when the immune system attacks the thyroid (the small gland in front of the neck), causing hyperthyroidism. Hyperthyroidism is when your body produces excess thyroid hormone.

Graves' disease may result in several serious health conditions, including eye disease.

Symptoms of Graves' eye disease

Graves's eye disease mainly causes bulging eyes (proptosis). Other symptoms are:

• Sensitivity to light
• Puffy eyelids
• Red, dry, gritty or irritated eyes
• Eye pressure or pain
• Eyelids that pull back more usually or don't close completely
• Difficulty moving the eyes when looking around
• Double vision

Graves' eye disease occurs for 1 – 2 years and often resolves on its own, but in a few cases, the swelling around the eyes can press the optic nerve (the nerve that connects the eyes to the brain), causing vision loss.

Can I have Graves' eye disease?

You are at risk of Graves' eye disease if you have Graves' disease. About one in three people with Graves' disease develop this eye condition.

Smoking also increases your risk of eye problems in those with Graves' disease. Consider quitting smoking if you smoke.

Graves' disease usually affects more women than men and occurs before age 40. You have a higher risk of Graves' disease if you have a family history of the condition or another autoimmune disease such as rheumatoid arthritis.

Causes of Graves' eye disease

In some cases, Graves' disease causes an immune attack on the muscles and other tissues surrounding the eyes. This may result in swelling behind the eye socket, making the eyes bulge.

The cause of Graves' disease is still unknown, but researchers believe people with some genes are more likely to develop the condition. Viruses and other environmental factors may act as a trigger for people who have these genes. It isn't contagious., so you can't get or transmit it to others.

How will my eye doctor diagnose Graves' eye disease?

An eye doctor can diagnose Graves' eye disease by conducting a physical eye exam. The doctor will closely examine the eyelids and eyes during the eye exam.

If your eye doctor suspects Graves' disease, you may need a blood test to check if your thyroid is functioning properly.

Treatment for Graves' eye disease

You will need treatment for thyroid issues if you have Graves' disease. In some cases, thyroid treatments help people with Graves's eye disease, but most people need separate treatments for their eye problems. These include:

• Over-the-counter eye drops

Using artificial tears is the most common treatment for irritated or dry eyes. This type of eye drop is available without a prescription. Over-the-counter ointments and gels are also available to make your eyes feel better.

• Prescription medicines

If the swelling behind your eyes is much, the doctor may recommend steroids such as prednisone or other medicines like rituximab to reduce the swelling. Your doctor can also recommend a new medicine only for Graves' eye disease known as Tepezza (teprotumumab).

• Quit smoking

Smoking can worsen Graves' eye disease, so quitting smoking is a vital lifestyle change if you have Graves' eye disease.

• Other lifestyle changes

The following steps can help ease some common Graves' eye disease symptoms.

• If your eyelids do not close completely, try tapping them shut to prevent dry eye at night.
• If you experience sensitivity to light, use over-the-counter eye drops and wear sunglasses when outside.
• If your eyes are puffy, try lifting the head of your bed so your head is higher than your body while sleeping. 

• Eyeglasses

 If you experience double vision, a special prescription lens, called prism prescription, can help correct double vision and improve your vision.

• Surgery

If Graves' disease affects your vision, your doctor may recommend orbital decompression surgery. This surgery helps enlarge the eye socket to ease pressure on the optic nerve and help your eye move to its correct position.

Your doctor may recommend eyelid surgery if your eyelids are pulling back too much to restore them to their normal position.

• Radiation

Radiation may be a treatment option for Graves' eye disease to reduce swelling in the tissues and muscles around the eyes.

At Optimal Vision, our experience eye doctor can carry out a physical eye exam to determine if you have Graves' eye disease. You can schedule an appointment for a physical eye exam by calling us on 020 7183 3725 or visit our clinic for a walk-in appointment with our eye doctor.