[Anonymous]

#1020025

Hello-

I am looking for some imput. I was diagnosed with Graves in early 2003, did PTU for a year, had a short span of remission, and then a strong recurrence followed by RAI in February. I have some “lid lag”, and dry, gritty eyes. I also get headaches behind my eyes (which seem to be aggrevated by stress). My endo says that she does not see signs of Graves Opthmology, just the “lig lag”. I am trying to manage the dry eyes with drops. The headaches really bring me down, and combined with the dry eye can makes things pretty miserable. Does anyone have any further suggestions for managing the eyes and the headaches? I have never been to an opthamologist b/c my endo said that she didn’t think it was necessary.

I am currently hypothyroid and slowly working my way up on synthroid (just got moved to 88mcg). Current TSH is 13 and T3 and T4 are below normal levels. Does the hypothyroid exacerbate the eyes? I am wondering why they seem to be getting worse again. I have fought the headaches and gritty eyes on and off my whole journey with Graves, and am trying to solve the puzzle of what sets them off. While in remission, they were managable with eye drops although direct sun exposure bothered them last summer. I really had no eye/headache issues going into RAI in February. Then, I had terrible headaches following RAI when I became severly hyperthyriod for about 6 weeks. Then, the headaches went away for a couple of months before coming back a few weeks ago.

I am wondering if there is anything else that I can do to make my eyes feel better; and I guess also wondering if it wouldn’t be worth it to try and see an opthamologist? Any suggestions?

Thanks,
Anne

[Anonymous]

#1075765

My recommendation would be to see an opthamologist. Eye issues, and especially the eye disease, needs to be treated by an opthamologist. The eye disease runs a separate course from the thyroid disease. Treating the thyroid disease doesn’t stop the eye disease from developing, nor does it help moderate it. They are separate.

Our endos do a check for eye muscle problems (the major symptom of the eye disease), but I am not sure how accurate it is. They ask us to watch a finger tip, or pencil point, that is being moved to the far ranges of our eye movement, and they watch to see if the eyes are focussing on the correct spot. So, it is safe to say that your endo is not seeing any gross problems if he/she is doing that during your exams.

One thing that does happen with thyroid disease — and mine has never gone away — is that the quality of our tears changes. The dry, gritty eyes is likely to be a symptom of that. (But again, an eye doctor needs to be consulted for a true diagnosis.) Our tears become less thick, more watery. Normal tears are thick and sit for long (relatively) periods of time ON the eye, lubricating constantly. When our tears become watery, the tears simply run out, without lubricating the eye very much. When the tear quality chaqnges, we need to put in artificial tears, often many times a day, to keep our eyes adequately lubricated. Otherwise, there is a huge risk that we will get corneal scratches. And once the cornea is scratched when our eyes are dry, the scratches take forever to heal.

Bobbi — NGDF Online Facilitator

[Anonymous]

#1075766

Anne, I agree with Bobbi that seeing an ophthalmologist is a good idea, especially since you’re having headaches. I had more headaches when I was hypothyroid and it’s possible that the cause of your headaches is related to your thyroid status, but this is something that your ophthalmologist should determine, since pressure behind the eye could be another cause. In any case, with that visit you will have a baseline measurement in case something changes in the future, and your corneas can be checked to see if there is damage on the surface.

While as Bobbi said the thyroid disease and eye disease are two separate processes, being hypothyroid actually does adversely affect the eye disease. I’ve had several exacerbations of eye disease, and the first thing my ophthalmologist always asks is whether I’m not hypothyroid.

By the way eyes that feel gritty are actually a sign that there may already be a small amount of damage to the cornea. By the time we feel this, it means they’re already too dry and we need to be more diligent about keeping drops in the eyes and protecting them from wind and other sources of moving air. You can wear wrap-style sun glasses when outdoors, or even swim goggles. I have severe dry eyes and have some prescription motorcycle goggles that even will handle built in prisms for my double vision. Dry eyes are no joke!

One more thing: Since many of us are going to be seeing these doctors for a very long time, I’ve found that learning to spell this difficult word correctly is worth the trouble. I break it down like this: Oph-thal-mol-o-gist and it’s easier for me that way. The other difficult word is Graves’ Eye Disease, or Oph-thal-mo-pa-thy, with the accent on the “mo” (the same place the accent is on ophthalmologist). That’s a tongue twister!

I hope your headaches clear up, and I really think you’ll find an ophthalmologist visit worthwhile.

Dianne W
GDF Online Facilitator

[Anonymous]

#1075767

I, too, have had more symptoms of the eye disease while hypothyroid. My opthalmologist explained this, however, as due to the fact that our bodies slow down, our muscles don’t work as well, etc., when we are hypothyroid. Not that “being” hypothyroid made the actual eye disease worse: it only made the symptoms more apparent. (For me, that is double vision, which only occurs when I’m hypo nowadays.) One doctor’s opinion, but I pass it along.

Bobbi — NGDF Online Facilitator

[Anonymous]

#1075768

On the subject of hypothyroidism affecting the course of eye disease, it’s been fairly well established now that both hyperthyroidism and hypothyroidism do have an effect on the severity of the eye disease and part of treatment for those of us with eye disease is to restore normal thyroid levels as soon as possible. My ophthalmologist worked at a large teaching hospital in L.A. and told me about this ten years ago. References to this are readily available in medical literature such as the Thyroid Disease Manager, one of our approved references, if you want to verify that.

Dianne W
NGDF Online Facilitator

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