Exophthalmos after Thyroid Treatment

Exophthalmos, a condition characterized by eyes that bulge unnaturally from their sockets, is often caused by thyroid disorders. However, thyroid treatments will not always cure this condition. Thyroid-related exophthalmos can worsen or even develop for the first time after the thyroid gland has been destroyed during treatment of thyroid-based diseases.

• Eyes afflicted with exophthalmos will often return to their normal state with time.

Identification

• In exophthalmos, the tissues behind the eye sockets swell, forcing the eyes to protrude out from the sockets and exposing a substantial amount of the whites of the eyes. In extreme cases, the eyes might bulge too far to allow the eyelids to close all the way. The most common culprit behind exophthalmos is a condition known as Graves' disease, which is caused by an overactive thyroid gland. Exophthalmos can linger after Graves' disease is controlled or cured.

Features

• In Graves' disease, the body's immune system attacks the thyroid gland, which then encourages the thyroid to produce excessive amounts of hormones. This can lead to heart problems, an unbalanced metabolism, skin irritation and exophthalmos. Roughly half of all sufferers of Graves' disease experience some degree of exophthalmos. In some cases, vision may be blurred or doubled, and ulcers may form on the corneas. Exophthalmos as a symptom of Graves' disease is known as Graves' ophthalmopathy.

Significance

• Doctors treat Graves' disease through the use of prescription medications designed to prevent the thyroid from producing hormones, through administering radioactive iodine to destroy the thyroid cells, or through surgery to remove the malfunctioning thyroid gland altogether. However, even after the thyroid gland has been controlled or destroyed, the exophthalmos can remain, or it can even present itself for the first time following completion of treatment. This is because exophthalmos is not caused by the overproduction of the thyroid hormone, but by the antibody that attacks the thyroid and signals it to produce the hormone. Even after the problems with the thyroid have been eliminated, the antibody can remain in the system.

Prevention/Solution

• Thyroid-related exophthalmos often clears up on its own. A doctor may prescribe corticosteroids to reduce the swelling in the eye sockets. In severe cases, surgery on the eye muscles or surgical removal of the bone between the sinuses and the eye socket might be performed to correct the appearance of exophthalmos.

Warning

• As thyroid conditions can affect the heart, sufferers of Graves' diseases should seek emergency medical treatment in case of an irregular or rapid heartbeat. Exophthalmos might also be caused by tumors behind the eyes or a serious bacterial infection, either of which could be potentially life-threatening.