Graves Disease

Definition | Symptoms |  Treatment |  Clinic Information

Definition
Graves disease (hyperthyroidism) is a medical condition in which an overactive thyroid gland secretes an excess amount of thyroid hormone. As a result, you may have an enlarged thyroid gland, palpitations, fast pulse, profuse sweating, high blood pressure, irritability, and a number of symptoms related to your eyes.

Symptoms of hyperthyroidism include fatigue, fast heartbeat, weight loss, heat intolerance, fine hair and diarrhea. Hypothyroidism may also cause fatigue, but with slow heartbeat, constipation and weight gain.

Note that symptoms of thyroid eye disease may be present even when tests show a normal level of thyroid hormone in the blood (called euthyroid). However, most patients with eye symptoms have abnormal blood levels of thyroid hormone.

Symptoms

• A "staring" appearance
• Dry eyes
• Swelling (edema) of the eyelids and tissue around the eye
• Double vision

In severe cases, the clear covering of the eye (cornea) may ulcerate, or the optic nerve may be damaged which results in a permanent loss of vision.

The symptoms described above may not necessarily mean that you have Graves disease. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.

Treatment
If your doctor suspects you have an overactive thyroid gland, your thyroid function must first be evaluated and appropriately treated. Once your thyroid function is treated and returned to normal, eye disease may continue to progress. Any residual eye problems should be followed and, if necessary, treated by an ophthalmologist.

Treatment for thyroid eye disease generally occurs in two phases. The first phase involves treating the active eye disease. The active period, which usually lasts two or more years, requires careful monitoring until stable. Treatment during the active phase of the disease focuses on preserving sight. Medical treatment, such as artificial tears and ointments, high doses of cortisone (steroids), surgery and possible radiation treatments may be required.

The second phase involves correcting unacceptable permanent changes which persist following stabilization of the active phase. In the second phase, treatment of permanent changes may require surgical correction of double vision, staring appearance or eye protrusion.

Many specialists feel that stopping smoking is essential in treating this disease.

Clinic Information
For more information, see the Comprehensive Ophthalmology Clinic and the complete Clinic Services listing of the U-M Kellogg Eye Center.