Graves and TED are different problems that sometimes go hand-in-hand. I know it is confusing. Basically, the eye disease USED to be called Graves’ Opthamopathy, which tied it in completely with Graves’. But doctors have discovered that people can get it who have OTHER thyroid problems, like Hashimotos, etc.. This doesn’t happen as frequently, but since it does, there has been a change in it’s name in the not too distant past. Now it is called Thyroid Eye Disease, or Thyroid Associated Ophthamopathy (TAO).
No, the diseases are not treated the same. Why? Because it is not thyroid hormone levels that cause the disease, and the treatments for our hyperthyroidism ONLY address thyroid hormone levels. Both diseases are caused by antibody action — they are autoimmune problems. But there is no medical treatment that can eliminate the antibodies causing the problems. So the medical treatments we have available deal with solving the PROBLEMS that the antibodies cause.
Yes, you can have Graves and not have visibly protruding eyes. In fact, most people who become hyperthyroid with Graves do NOT get the type of eyes that you are thinking of. Doctors are starting to think that the majority of those of us with Graves get “some” eye muscle changes due to the disease. But the issue is really whether those changes create distinct and adverse symptoms — and the lion’s share of the time, they don’t.
There are some eye issues that distinctly have to do with thyroid hormone levels. There is increased sensitivity to light. There can be a tightening of the upper eyelids, which makes our eyes more wide open than normal. This exposes more of the eye to the air, and causes them to feel very dry. The quality, consistency, of our tears may change, making them less efficient a lubricant for the eyes, which also adds to the dryness. There is usually some abatement (if not complete abatement) of these symptoms once our thyroid hormone levels get back to normal. But the eye disease itself is something that affects the MUSCLES of the eyes, causing them to thicken and stiffen. That is where the vision problems start to occur, IF they are going to occur. And the muscle problem is due to antibodies, not thyroid hormone levels.
But, I think the point is you don’t know whether to be worried about your eyes or not. Or you ARE worried and need some more information. The best thing you can do is get yourself to an ophthamologist who can tell you what, if anything, is happening to your eyes. Even if your eyes are OK right now, going to an ophtho now can be comforting if only because it helps establish a working relationship with this type of doctor. He/she will see your eyes in the current state and be able to assess any changes later on (should they occur). And he or she will be the best person to answer any questions that you have about your own eyes.
Wishing you good health,
Bobbi — NGDF Asst. Online Facilitator
