Eye problems due to underactive thyroid gland

The thyroid is a butterfly-shaped gland located at the bottom of the front of the neck. The thyroid gland regulates thyroid hormone and plays an important role in metabolism. Hypothyroidism is a medical condition in which the thyroid gland is underactive, resulting in low thyroid hormone levels in the body. This disease is the result of a deficiency of iodine, surgery, inadequate stimulation of the thyroid gland or due to the treatment of certain diseases. Hypothyroidism also occasionally causes eye problems. Prompt diagnosis of the underlying cause of reduced thyroid function is an important factor in determining the appropriate treatment for eye problems associated with hypothyroidism.

  • Exophthalmia and dry eyes in Graves’ eye disease
  • Drooping eyelids due to reduced thyroid function
  • Damage to the optic nerve due to underactive thyroid gland
  • Swelling around the eyes in hypothyroidism

Exophthalmia and dry eyes in Graves’ eye disease

Most often, thyroid eye disease appears with a form of overactive thyroid disease known as Graves’ disease (autoimmune condition involving overproduction of thyroid hormones). Thyroid eye disease may also occur in patients with hypothyroidism. The condition occurs when antithyroid antibodies produced by the immune system also attack the soft tissues and muscles of the eye.

Bulging eyes

Exophthalmia (bulging eyes) is a characteristic of Graves’ eye disease (thyroid eye disease). The autoimmune attack on the tissues of the eye socket causes the eyes to swell and the eyeballs to be pushed forward. In pronounced exophthalmia, the patient is unable to close the eyelids completely, making the eyes vulnerable and the patient quickly develops dry eyes. Dry eyes usually cause irritation, redness of the eyes, swollen eyes, inflamed eyes (eye inflammation) and a (gritty feeling in the eyes).

Scars on the cornea

In severe cases, thyroid eye disease (and associated dry eyes) leads to the development of ulcers on the surface of the eye (corneal ulcer). The ulcers cause scarring of the cornea, the clear area at the front of the eye. This may result in permanent vision loss.

Drooping eyelids due to reduced thyroid function

Drooping eyelids or ptosis are common in patients with hypothyroidism. The level of thyroid hormones in the body determines how the nervous system handles the position of the eyelid. Decreased nerve stimulation of the eyelids due to hypothyroidism leads to a drooping eyelid. Severe ptosis may partially obscure the visual field, resulting in reduced vision.

Damage to the optic nerve due to underactive thyroid gland

Thyroid eye disease may cause swelling of the soft tissue of the eye socket. This causes damage to the optic nerve (opticus nervicus). This nerve serves as a communication circuit between the eye and the brain. Compression of the optic nerve leads to permanent damage, such as loss of vision in the affected eye. About 5 percent of patients with thyroid eye disease eventually develop optic nerve problems. Intensive medical treatment reduces the risk of permanent damage to the optic nerve caused by thyroid eye disease.

Swelling around the eyes in hypothyroidism

Patients with hypothyroidism develop swelling around the eyes and face. In this condition, mucus-like proteins accumulate in the deep layers of the skin. Normally, the proteins and therefore the swelling around the eyes disappear when the patient receives treatment for hypothyroidism.