Graves’ disease (thyroid eye disease) is a disorder of the orbit (the bony cavity that holds the eye). It is characterized by swelling of tissues, with abnormal accumulation of water and white blood cells, which can cause the eye to protrude. This pressure from behind the eye can result in double vision and possible damage to vision itself by compressing the optic nerve or by elevating pressure inside the eye (glaucoma). Patients with Graves' disease often have enlargement of the eyelid openings and hence, a staring expression. When severe, the combined protrusion of the eyeball and retraction of the lids may cause the cornea to become dry and subsequently scarred from lack of protection.
The cause of Graves’ disease is not precisely understood. It is more prevalent among women than men. It may be associated with overactivity or underactivity of the thyroid gland. The disease runs an average course of one to two years, during which time symptoms worsen at first, and then gradually improve. Some patients may return to normalcy without treatment. Others may reach a stable state with minimal disability. Although uncommon, patients with overt manifestations of Graves’ disease may experience severe double vision, severe corneal and optic nerve damage, and even blindness.
Unattractive appearance; eye discomfort such as aching or a sandy, gritty sensation; poor or double vision
Double Vision (diplopia)
Mild cases: artificial tears and lubricating ophthalmic ointment to relieve dry eyes;
Severe cases: administration of corticosteroid medications, external beam radiation, or a combination of these to reduce pressure on the optic nerve