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Graves' ophthalmopathy, also known as thyroid eye disease (TED), is an autoimmune inflammatory disorder of the orbit and periorbital tissues, characterized by upper eyelid retraction, lid lag, swelling, redness (), conjunctivitis, and bulging eyes (exophthalmos). [1]
Difficulty closing eyes can be treated with lubricant gel at night, or with tape on the eyes to enable full, deep sleep. Orbital decompression can be performed to enable bulging eyes to retreat back into the head. Bone is removed from the skull behind the eyes, and space is made for the muscles and fatty tissue to fall back into the skull. [35]
The leading cause of hypothyroidism is Hashimoto’s disease (also known as Hashimoto’s thyroiditis, chronic autoimmune thyroiditis or lymphocytic thyroiditis), per Cleveland Clinic.
Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit.Exophthalmos can be either bilateral (as is often seen in Graves' disease) or unilateral (as is often seen in an orbital tumor).
There are many diseases known to cause ocular or visual changes. Diabetes , for example, is the leading cause of new cases of blindness in those aged 20–74, with ocular manifestations such as diabetic retinopathy and macular edema affecting up to 80% of those who have had the disease for 15 years or more.
Hyperthyroidism almost always causes general eye symptoms like dryness and irritation, regardless of what the cause of the hyperthyroid state is. However, these need to be distinguished from Graves' ophthalmopathy, which can only occur in patients who have Graves' disease.
Bulging eyes: where the eye (one or both) protrudes or distends out of its orbit. Left untreated, bulging eyes may lead to eye dryness, pain and vision loss [3] Cytomegalovirus (CMV) Retinitis: This is an inflammation of the retina caused by infection, which can result in blindness.
Hyperthyroidism has also been linked to an enlarged thyroid gland (goiter), irregular menstrual cycles, high blood pressure, brittle hair, and more prominent eyes, per Johns Hopkins Medicine.