Your chances of going blind from Graves' disease are very small. The chances of having optic nerve problems from Graves' disease is under 5 percent. In those people, less than 25 percent develop permanent vision loss. The vast majority of people with Graves' disease do not go blind.
Graves' Disease
Graves' disease is an autoimmune condition that makes the thyroid to overproduce thyroid hormone (hyperthyroidism). Symptoms include irregular heartbeat, nervousness, mood changes, fatigue, and the appearance of bulging eyes. Treatments include antithyroid medication, radioactive iodine and surgery.
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It is best to have eyelid surgery for Graves' disease once the disease is stable. That means your eyes are not getting worse or changing over a six-month period. First you should get eye socket surgery for bulging, if needed, followed by eye muscle surgery to correct double vision as well. You should get eyelid surgery last after the eye socket or eye muscles are taken care of. Eyelid surgery at the same time as orbital decompression or eye muscle surgery is not recommended.
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If you have been diagnosed with Graves' disease, if you are a smoker the most important thing is to stop. It makes Graves' disease worse and increases the risk of going blind. If you are exposed to secondhand smoke, it is best if you avoid it. Graves' disease symptoms can be improved through supportive measures. Sleeping with your head elevated (head of the bed on concrete blocks) will reduce puffiness and swelling in your eyes.
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You may see several kinds of doctors for Graves' disease, including the following:
- Endocrinologist — An endocrinologist is a doctor who treats hormone issues in the body. In Graves' disease, these doctors will check for thyroid problems and control them. Graves' eye disease patients have the best outcomes with well-controlled thyroid function.
- Primary care doctor — Your primary care doctor will be helpful for coordinating your care with the other doctors. Any patient with a medical issue needs a good quarterback. Your primary care doctor can be critical in this role.
- Ophthalmologist/optometrist — Your ophthalmologist or optometrist can check your vision and look for vision loss. They can test your vision with visual fields and imaging of the optic nerve. If your eye doctor is not comfortable treating Graves' eye disease, you should see a specialist, such as an oculoplastic surgeon or neuro-ophthalmologist.
- Oculoplastic surgeon — Your oculoplastic surgeon is the surgeon who will perform your eye socket and eyelid surgery if needed.
- Strabismus surgeon — This is the surgeon who performs double vision surgery on the eye muscles. They also can be helpful to prescribe prisms for your glasses.
- Neuro-ophthalmologist — This eye doctor is a specialist in optic nerve damage. In some cases they may be recruited to help diagnose, manage and treat a problem with the optic nerve. In other cases, they may be asked to evaluate people who their ophthalmologist or optometrist believes may have Graves' eye disease.
- Psychologist/psychiatrist — These doctors can be helpful to aid people dealing with the psychological and/or emotional issues from developing Graves' disease. This can be critical for mental well-being during the disease course.
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The cause of Graves' disease is unknown, but there may be something in the genes that may increase the risk for development of the disease. Graves' disease is not caused by vaccines, diseases, trauma or any other cause. A person cannot “catch” Graves' disease from someone else.
Graves' disease is a disease of the immune system. The same way that some people get autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, or lupus, some people develop Graves' disease. The only environmental factor that plays a role in Graves' disease is smoking. Smokers are at a higher risk for developing Graves' disease because smoking inherently messes with the immune system.
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If you have Graves' disease it should not affect your lifestyle, unless you smoke. Smoking will make Graves' disease symptoms a lot worse and increase the risks of blinding you. Other than that, you can do everything you did before you had Graves' disease. It is important to try to live as normal a life as possible after diagnosis of Graves' disease.
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See All 3 AnswersGraves’ disease can affect your eyes in many different ways. The symptoms may vary from person to person and may fluctuate or clear up suddenly without any treatment. Following are several common eye problems associated with the disease:
Eye protrusion: The excess hormones in Graves’ disease cause the muscles in and around the eye to swell and push the eye forward. This eye bulge is a characteristic symptom of Graves’ disease and causes patients to look as if they are constantly staring.
Eyelid retraction: The combination of eyelid swelling and eye protrusion may cause the eyelids to retract and reveal the white parts of the eye above and below the iris.
Dry eye: Due to eye protrusion and eyelid retraction, your eyes are more exposed to environmental elements, such as wind and dust, and may become very dry. Dry eye can cause several side effects, including:
- Irritation and discomfort of the eye
- Inflammation of the eye
- Excessive tearing
- Light sensitivity
- Blurred vision
- Ulcers on the cornea (the clear front window of the eye)
- Scarring of the cornea
If untreated, severe dry eye can lead to vision loss.
Double vision: Muscle swelling may cause double vision. It may occur constantly or only when looking in certain directions. Prolonged and excessive muscle swelling can also compress and damage the optic nerve (the nerve in the eye that sends visual impulses to the brain) and in severe cases cause blindness.
Eye “bags”: Eyelid swelling can also cause fatty tissue around the eyes to bulge forward. This causes the appearance of “bags” around the eyes and can make patients look prematurely aged.
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Dr. William D. Knopf, MD , Cardiology (Cardiovascular Disease), answered on behalf of Piedmont Heart InstituteAfter treatment with surgery or radioactive iodine, thyroid-stimulating antibodies can still be present in blood even though thyroid levels are normal. In a pregnant woman who received either of these treatments, the antibodies she produces may travel across the placenta to the baby's bloodstream and stimulate the fetal thyroid. A pregnant woman who has been treated with surgery or radioactive iodine should inform her doctor so that her baby can be monitored for thyroid-related problems later in the pregnancy.
This answer is based upon information from the National Institute of Diabetes and Digestive and Kidney Disease. -
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See All 6 AnswersAn overactive thyroid is the most common cause of hyperthyroidism and can be caused by Graves' disease (also known as diffuse toxic goiter or when the whole thyroid is hyperactive), toxic multinodular goiter (when more than one nodule is hyperactive), or a toxic nodule (when just one nodule is hyperactive). Approximately 1 million patients in the United States have Graves' disease, the most common cause of hyperthyroidism. Graves’ disease is an auto-immune process where the body creates antibodies to the thyroid that then attach to the thyroid and “turn it on” thus causing the thyroid to release more thyroid hormone than normal and thus making the patient hyperthyroid.
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Surgery for Graves’ disease involves the removal of the entire thyroid gland by a total thyroidectomy. The surgery can be done very safely, and results in a quick and permanent resolution of hyperthyroidism. It is equally effective and safe as radioactive iodine ablation. For some patient populations it may be their best option, including those with thyroid enlargement and compressive symptoms, suspicious nodules (or growths), patients needing rapid control of their disease, patients with significant eye problems, or women who are pregnant or nursing.
For more information go the endocrinediseases.org: Hyperthyroidism