i realize that in extreme cases of graves disease, bulging eyes can be a symptom. does anyone here know what is actually going on that causes the eyes to bulge out, and are the eyes actually getting larger or is there something that makes them protrude while staying the same size?
by that rationale, does hypothyroidism cause the eyes to recess or get smaller? this is going to sound so absolutely hypochondriacal and crazy but i swear my eyes feel smaller and/or more sunken in my sockets. maybe this is just because my face is more swollen, i dont know. but i definitely get recurring 'dry eye' and i wonder if there is more to it - that is, an actual decrease in eye size. i know this sounds crazy!!!!! i apologize for sounding so extreme but i have to find out if anyone else has any opinion on this.
Thyroid Eye Disease (TED) often occurs with graves disease but is actually a separate entity (not everyone with Graves has it, some patients with Hashimoto's can develop it also. A particular autoimmune reaction to the tissues behind the eye cause the eye to bulge out. There is not an inverse "eye shrinking" condition that I know of, although I suppose someone who had TED and got better would see shrinkage from their former bulging state. Dry eyes can be due to Sjogren's syndrome, which is another autoimmune condition that causes dry eyes and dry mouth.
The things that I have read about TED is that the fat tissue behind the eyes get attacked which causes the eyes to protrude. As well as the muscles get attacked. I have seen people whos eyes seem sunkin in but I have no idea why. I have TED and have had to be on meds and while they are working my eyes don't really seem to get smaller, they just seem to go back into place. To me looking at my eyes in a mirror when they are protruding looks like you can see all of my iris and when they are getting better then you can only see half of it. There are other things that have eye involvement, if I were you I would ask my Doc about what they think.
Last edited by lookin4aclue; 05-01-2006 at 07:34 AM.
Yes, it would be best to consult with an optho that is familiar with "treating" TED.
As far as the buldging....I think there are several variables that can happen. The muscle and fatty tissue around the eye can become inflamed as mentioned above.
Also, I have heard and read that the muscles can become constricted causing lid retraction (lids won't close all the way). And the eye muscles can constrict in the eye socket to the point they essentially "shrink" the space for the eyeball to "nest". This is what makes the eye "buldge" out of the socket.
All this is also what can put pressure on the optic nerve causing vision problems. All the muscle pressure also contributes to pressure on the eye itself. That is why pressure tests are good ideas.
Hope that helps...
Hyperkim
PS. Please note I do not have full blown TED. I think I have mild TED with minimal eye swelling or puffiness and eye muscle soreness occasionally. Having these problems I have checked out research and read other's personal stories a little more attentively because I want to know what could happen. And I am not a dr.
lookin4aclue,
What meds are you one for your TED? I have a mild case eyelid retraction in one eye, dry eye and can no longer wear contact lenses. I have hashimotos and am taking Armour . You mention that your eyes go back to being normal, how long did this take? I am considering to have surgery to correct the eyelid retraction but If there is hope they will go back to normal in a reasonable amount of time I will wait. Any info would be appreciated.
I have been on prednisone for the inflamation, it seems to work but if they take you off of them to soon then they will again get inflamed and you will have to start the course of them all over again, in some it seems to work. I have been on them off and on since late December. I am on the third course of them, and my doc said that if they didn't seem to be working on this time that I would have to see an orbital sergon. They seem to be working this time, but I lowered the dose a week ago and they started to get inflammed again, so he upped it again. This does sometimes work for people but it tends to happen again. I really don't want to do the orbital thing due to the fact that I have four kids and really can't. I also have to use eye drops about 6 times a day to keep them from tearing and getting overly dry. The pain is not as bad as it was when I started, and I don't seem to have the double vision like I did. I have lid retraction, and lid lag, don't ask me how they are going to fix that, but if it's not real bad then I'll let it be for awhile. I have read that there is some other meds for this that you put in at night to keep the eyes moist when you are sleeping. I haven't had those yet, but will be asking for them today when I see the doc. He keeps a close look on my eyes. The pressure in them have been checked every month since Dec. It's within the normal ranges now but wasn't when I started this whole thing. The side effects from the meds are bad though. I have gain almost 20lbs!! Like I needed that! I'm already overweight thanks to being hypo! I hope this helps you some, you really should have the eye doc call an orbital doc to find out what meds you should try before going threw with the other opption, this is better than that I would think. They started me off on 40mg for a week then 30mg for a week then 20 mg for a week(this is where it starts to be to week for me)and then 10 mg for a week, and then 5 mg for a week. Anything under about 20 is just there to tapper you off the meds because stopping them to soon can have bad effects. Hope this helps.
thank you lookin4aclue. I see an optho for the third time this week and will try to get a CT scan to see if I have any orbital swelling and ask to have pressure checked. How is that done?
There are two ways, one is the way most doctors check when you go in to get glasses or something(not as good), and then the other way is the doc puts drops in to I guess numb it(the eye)feels good to me, I would like some of those drops to take home what ever they are. Then they take some kind of thing and put it up to the eye and look into it, it has some kind of purple lighted hue. Doesn't hurt, but still makes ya jump just like the puff of air in your eye. I have already had the Cat scan and it showed swelling but no obtical nerve invovlement. So so far so good.
Before I knew I had Hashi's (and before I had any idea what a thyroid was), I had thought it was weird that one eye seemed a lot smaller in photos. I thought maybe I was dropping with age (I'm 38). I compared older photos to recent ones and my eyes used to look the same size. After being on Synthroid a while I noticed my eyes were the same size again. Hmmm.
So I went to the Optho and all he did was give me steriod drops and said my eyelid retraction was not bad enough to warrant anything further. I hate HMO's, I will be changing to a PPO but not until September. He said he could not predict if it will get worse and said it could last for 5 years then settle down. Anyone else have eyelid retraction that was mild and never got worse? I have hashi's not graves, just had a tsi and they tell me it is normal. I believe the reading was 83 with no ranges given. Any help advice would be appreciated.
weird eye question 
i apologize for sounding so extreme but i have to find out if anyone else has any opinion on this. 
