Graves' Disease

In Graves' disease, the thyroid gland goes into overdrive and produces more hormones than the body requires. As a result, people with Graves' disease become very "hyper," and exhibit a variety of symptoms: weight loss despite increased appetite, irritability, heat intolerance, irregular heartbeats, and in women, changes in menstrual cycles.

In addition to these symptoms, some people with Graves' disease develop skin problems that cause the lower legs to become red, shiny and swollen. Until the patient receives treatment for Graves' disease (see below), creams and lotions can temporarily relieve some of these symptoms.

Another condition that may develop with Graves' disease is bulging of the eyes. This is caused when fluid builds up behind the eyeball, causing it to protrude out of the orbit. In addition to the cosmetic changes this causes to the eye, thyroid eye disease includes additional symptoms such as dry eye, redness and swelling, excess tearing, sensitivity to light, blurring and double vision.

Currently, there are three treatments for Graves' disease. Together with your physician, you can discuss which one is best for you.

• Anti-thyroid medications which block the affects of the excess thyroid hormones.
• One-time treatment with radioactive iodine, which essentially destroys the thyroid gland. Afterward, the patient will need to take thyroid hormone replacement drugs.
• Surgery to remove most of the thyroid gland. As with radioactive iodine treatment, the patient will need to take supplemental thyroid medication after surgery.

The Thyroid Gland

Located on either side of the windpipe, the thyroid gland is responsible for the production of hormones that communicate with many of our biological systems, including metabolism, body temperature, energy and fertility.

Under normal circumstances, the thyroid is controlled by the pituitary gland, which works in tandem with the thyroid to deliver the correct amount of hormones when needed by the body.

In Graves' disease, the thyroid gland goes into overdrive and produces more hormones than the body requires. As a result, people with Graves' disease become very "hyper," and exhibit a variety of symptoms: weight loss despite increased appetite, irritability, heat intolerance, irregular heartbeats, and in women, changes in menstrual cycles.

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The Lacrimal System

The lacrimal (tear) system is a miniature drainage network which prevents tears from continuously rolling down the cheeks.

From the surface of the eye, the tears flow along the edge of the lids toward the nose. Just before reaching the corner of the eye, the tears slide into two tiny drain tubes, and then into a larger tube which carries the tears into the nose. This explains why crying often causes one to blow one's nose.

Many problems may cause the tear system to drain poorly. For instance, an accident may cut one of the two tiny drainage tubes, a long-standing infection may scar these tubes, or tumors may invade parts of the tear system.

All of these may lead to poor drainage causing the tears to well up in the eye and roll down the cheek.

Fortunately, surgery or other kinds of procedures can usually relieve this uncomfortable situation and restore a functional system.

Many infants, about 20 percent, are born with tear ducts or drain tubes that have not opened. This usually leads to a chronic and low-grade infection in the tear drainage system. That causes a mixture of mucus and pus to accumulate in the inner corner of the eyes, between the lids. Parents should wipe that away with anything clean, such as a tissue. The volume of this accumulation can be reduced by applying antibiotic dropper ointment to the affected eye. Nearly all of the time, the blockage of this drainage system will open by one year of age.

If the duct has not opened by the child's first birthday, an ophthalmologist may open the blocked naso-lacrimal duct by a simple procedure called probing of the naso-lacrimal system. This brief procedure requires a brief period of general anesthesia and a short outpatient stay in the hospital. Some ophthalmologists probe in the office, without general anesthesia, but usually before the child is one year old.

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Graves' Eye Disease or Thyroid Eye Disease

Graves' disease may develop when the thyroid gland is hyperactive (overactive). This condition may occur to men and women at any age but mostly affects women age 20 to 60 years. Although the cause of hyperactive thyroid gland, also known as "hyperthyroidism," is unknown, it is rarely life threatening. Some theories suggest it may be the result of an autoimmune disorder. It does, however, affect the thyroid gland, the skin and the eyes.

Graves' thyroid disease can result in severe bulging of the eyes, lid retraction, poor eye movement and loss of vision. These can be improved by orbital, muscle and lid surgery, usually performed in several stages.

Every patient with Graves' disease should have regular eye examinations by an ophthalmologist.

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Autoimmune Disorder

The human body creates special proteins known as antibodies to fight off infection, other diseases and anything the body considers foreign. Sometimes, however, the body mistakenly targets healthy cells and launches an attack on itself. This is called an autoimmune reaction. Graves' disease is suspected to be an autoimmune disorder.

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