Thyroid and Dry Eyes


The thyroid is a small, butterfly-shaped gland in the front of your neck and is essential for your metabolism to work properly. Thyroid hormones control the way your body uses energy, so they affect nearly every organ in your body, even the way your heart beats.

It mainly produces two hormones: triiodothyronine (T3) and thyroxine (T4), which control the hormone balance within the body. If this balance is disrupted, the entire metabolism is affected.

Two types of thyroid disease:

  • Hyperthyroidism: excessive hormone production
  • Hypothyroidism: insufficient hormone production

Hyperthyroidism manifests as an acceleration of the majority of body functions. In hypothyroidism, the thyroid gland doesn’t produce enough hormones. Therefore tear production is reduced. Don’t forget that tears help to protect, moisten, lubricate and even clean the eyes. If insufficient tears are produced, the eyes will become dry and symptoms of dry eye may appear.

Graves’ disease, is an autoimmune disease that is usually related to hyperthyroidism but can also affect people with hypothyroidism. In Graves’ inflammation and other immune system events affect muscles and other tissues around your eyes. Graves’ disease is caused by a malfunction in the body’s disease-fighting immune system. It’s unknown why this happens.

The immune system produces antibodies designed to target a specific virus, bacterium or other foreign substance. In Graves’ disease, for unknown reasons, the immune system produces an antibody to one part of the cells in the hormone-producing gland in the neck thyroid gland. With Graves’ disease, your immune system attacks your thyroid gland, causing it to make more thyroid hormones than your body needs. As a result, many of your body’s functions speed up.

Although Graves’ disease may affect anyone. The primary treatment goals are to reduce the amount of thyroid hormones that the body produces and lessen the severity of symptoms.

Common signs and symptoms of Graves’ disease include:

  • Anxiety and irritability
  • A fine tremor of the hands or fingers
  • Heat sensitivity and an increase in perspiration or warm, moist skin
  • Weight loss, despite normal eating habits
  • Enlargement of the thyroid gland (goiter)
  • Change in menstrual cycles
  • Erectile dysfunction or reduced libido
  • Frequent bowel movements
  • Bulging eyes (Graves’ ophthalmopathy)
  • Fatigue
  • Thick, red skin usually on the shins or tops of the feet (Graves’ dermopathy)
  • Rapid or irregular heartbeat (palpitations)
  • Sleep disturbance
  • Gritty sensation in the eyes
  • Pressure or pain in the eyes
  • Puffy or retracted eyelids
  • Reddened or inflamed eyes
  • Light sensitivity
  • Double vision
  • Vision loss

Another symptom of Graves disease is swelling of the muscles and tissues behind the eyeball. The eyes are therefore pushed forward, preventing the eyelids from blinking completely. Blinking plays a fundamental role in keeping the eyes hydrated and therefore in limiting dry eye.

Although anyone can develop Graves’ disease, many factors can increase the risk of disease:

  • Family history.
  • Sex. Women are much more likely to develop Graves’ disease than men.
  • Age. Graves’ disease usually develops in people before age 40.
  • People with other disorders of the immune system, such as type 1 diabetes or rheumatoid arthritis.
  • Emotional or physical stress. Stressful life events or illness may act as a trigger for the onset of Graves’ disease among people who have genes that increase their risk.
  • Pregnancy.
  • Smoking. Cigarette smoking, which can affect the immune system, increases the risk of Graves’ disease.

How do doctors diagnose Graves’ disease?

  • Blood tests.
  • Radioactive iodine uptake test. This test measures the amount of iodine your thyroid is taking up from your bloodstream to make thyroid hormones. If your thyroid is taking up large amounts of iodine, you may have Graves’ disease.
  • Thyroid scan. This test, often done together with the radioactive iodine uptake test, shows how and where iodine is distributed in your thyroid. With Graves’ disease, the iodine shows up throughout the gland.
  • Doppler blood flow measurement NIH external link. This test, also called Doppler ultrasound, uses sound waves to detect increased blood flow in your thyroid due to Graves’ disease. Your doctor may order this test if radioactive iodine uptake is not a good option for you, such as during pregnancy or breastfeeding.

Your doctor will take your medical history and perform a physical exam to look for signs of Graves’ disease. To confirm a diagnosis of Graves’ disease, your doctor may order one or more of these thyroid tests

A few tips for controlling dry eyes

  • Use of artificial tears in the form of eye drops. Keep your eyes hydrated, to compensate for the lack of natural tears.
  • Daily eyelid hygiene is important.
  • Warm your eyelids using a warm mask or warm compresses. For 10–15 minutes.
  • Try to protect your eyes from external factors. Wind, sun and smoke are all causes of dry eye.
  • Make sure you blink fully and regularly. This will help to spread the tear film properly and so keep your eyes hydrated. You should be blinking around 15 times per minute. 1 blink every four seconds
  • Hydrate yourself. Make sure you drink plenty of water. A well-hydrated body is a healthy body, the same goes for the eyes. If your body is well hydrated, your eyes will be too.
  • Sunglasses can help with light sensitivity.

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