More than meets the eye
Although unusual, Sangeetha’s condition isn’t uncommon.
CHENNAI: In 2020, Sangeetha*, a young woman suffering from hyperthyroidism, started observing frequent discomfort in her eyes. Dismissing her watery eyes as an allergy reaction, she even attributed it to her habit of rubbing them often. Last year, one of her eyes started bulging out. “This caused me severe distress. By then, there was swelling in both my eyes. They would not properly close even when I was trying to sleep – the whites of my eyes would always be visible,” says Sangeetha, as she recounted her ordeal. Naturally, this had a psychological impact on her. “I wanted to avoid stares and questions about my eyes from curious passersby, so I stopped going out, and said no to selfies with friends. My self-esteem was badly hit,” she reveals.
Although unusual, Sangeetha’s condition isn’t uncommon. Her symptoms fall on the spectrum of Thyroid Eye Disease (or TED). It occurs when the body’s immune system develops antibodies to its own cells which then attacks the eye area, say specialists. In most cases, it is this same autoimmune condition that also affects the thyroid gland in the neck area, causing hyper and hypothyroidism (excess and insufficient production of the thyroid hormone, respectively). Doctors cite age, diabetes, and smoking as additional risk factors.
The TED talk
TED causes inflammation in the various tissues behind the eyeball and around the eye. “When the eyes swell, they look bulgy, causing a staring appearance,” explains Dr Priti Udhay, head of oculoplasty & aesthetic services, Dr Agarwal’s Eye Hospital. The wide range of aggravating symptoms include squints, bloodshot eyes, and puffiness of eyelids. Double vision, corneal ulcers and glaucoma are signs that the disease has progressed to an advanced stage, doctors say.
“Ointments, lubricants, immunosuppressants like steroids can provide relief. Radiation therapy to the thyroid glands can curb hormonal overproduction,” says Dr Aafrin Shabbir, internal medicine consultant, Gleneagles Global Hospital.
Treating the thyroid condition may rein in disease progression to an extent, but that does not entirely address TED. “My various eye issues did not disappear even after consistent treatment restored my thyroid levels to a state of normalcy,” says Sangeetha. TED treatment requires a multidisciplinary approach where specialists in endocrinology, ophthalmology, cornea, glaucoma, immunology, and psychotherapy, too, need to evaluate the patient’s condition. Oculoplastic surgeons (ophthalmologists specialising in plastic surgery) can even aid in improving appearance and function of the eye, suggests Dr Priti. “Advanced keyhole oculoplastic surgeries like eye muscle correction and eyelid correction if there is lid retraction (when eyelids get drawn back), are now daycare procedures with no visible surgical scars,” she notes.
Sangeetha recently underwent an orbital decompression surgery to alleviate her bulgy eye condition. Feeling hopeful about a recovery, she says, “My stress over my health has now diminished. I would suggest people with symptoms like mine to avoid self-diagnoses and generic advice.” Not paying heed to vital signs and not consulting the right specialists is unadvisable. Early diagnosis and intervention could even avert potential vision loss. Regular and detailed eye examinations are a must for those with thyroid problems, urged specialists.(*Name changed)
Eye-ing chronic warning signs
Puffiness, dryness, redness, wateriness, irritation
Double vision, especially on prolonged reading
Inability to completely close the eyes
Decrease or blurring of vision, especially with one eye closed
Swelling of eyelids in mornings; when exposed to sunlight.