Staying Fit
If you look in the bathroom mirror and see red, swollen, irritated eyes staring back, you might be tempted to blame ragweed. But seasonal allergies may not be the culprit. A condition known as thyroid eye disease can play havoc on your eyes’ appearance — as well as your vision. It happens when your body’s immune cells attack the muscles and connective tissue behind the eye, causing inflammation.
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What is it?
Thyroid eye disease (TED for short) is also known as Graves’ ophthalmopathy or Graves’ eye disease — and with good reason. It usually develops in people with an overactive thyroid caused by Graves’ disease, an autoimmune disorder that causes the thyroid to produce more hormones than the body needs (hyperthyroidism). In fact, approximately 1 in 3 people with Graves’ disease will develop the eye problems.
Why? Our immune cells make antibodies, and researchers suspect that typically any place in the body that expresses a thyroid receptor can get attacked by those antibodies. The thyroid obviously expresses thyroid receptors — and it just so happens that thyroid receptors can also be found behind the eye.
“That provides some of the explanation for why the eyes become involved,” says Simon Pearce, a professor of endocrinology at Britain’s Newcastle University. “There’s some shared protein between the thyroid and the muscles and tissues behind the eye.”
Even so, people with hypothyroidism (an underactive thyroid) or even normal hormone levels can also have TED, though this occurs a lot less commonly.
Common symptoms
Symptoms can range from mild to severe, but only a very small percentage of people will experience TED that threatens their sight. In the early stages of the disease, eyes appear red and swollen. They might feel dry, itchy and irritated (imagine getting a bit of sand in your eyes). The eyelids are often retracted — meaning the upper lid is too high and you can actually see the white of the eye above the cornea — giving people a slightly startled appearance.
“Because more of the white is exposed, the conjunctiva [the clear mucous membrane that covers the surface of the eyeball] gets dry,” Pearce says.
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