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Behind Her Dry Eye Syndrome: Thyroid Disease
When his middle-aged patient complained that her eyes were “dry, gritty and puffy at times,” VSP network doctor Bryan D. Granger, O.D., asked himself two key questions about her ongoing complaint.
Question 1: Was the patient suffering from dry eye syndrome, a chronic disorder in which a lack of lubricating moisture can cause significant discomfort and even cause vision-threatening scarring of sensitive eye tissues?
Question 2: If so, was the dry eye perhaps related to an underlying health condition – an ailment known as hyperthyroidism – which occurs when the thyroid gland secretes too much hormone? The patient had mentioned having this condition as Dr. Granger was taking her medical history.
Determined to find the answers, Dr. Granger began examining the patient’s cornea, the transparent front part of the eye. What he found were several signs of hyperthyroidism-related dry eye syndrome – signs that included lack of moisture, inflammation, irritated membranes and a slight bulging of the eyeball caused by swelling of the tissues around the eyes.
Once he had a clear understanding of the relationship between the patient’s eye problems and her underlying health condition, Dr. Granger was able to begin treating the dry eye syndrome effectively.
“This patient first visited me a year ago for a regular yearly eye exam, and I was glad she did,” says the 39-year-old optometrist, who practices in New Iberia, La. “Over the years, I’ve had several cases like hers, in which a patient with a thyroid disorder was also struggling with dry eye.
“Fortunately, making the connection between the dry eye and the underlying disorder made the eye problem easier to treat. Initially, I prescribed lubricating eye drops. Two weeks later, I checked her progress and prescribed an eye ointment for use at bedtime.”
During the next few months, Dr. Granger monitored his patient carefully and was encouraged when her symptoms began to recede. Also, there was no scarring of her corneal tissue. Notes the doctor: “The risk here is that scarring caused by untreated thyroid-related dry eye can sometimes erode vision, or even destroy it.
“But that didn’t happen with this patient. As a matter of fact, I just saw her again yesterday for her annual checkup – and she told me she’s experiencing very little discomfort. She’s seeing well with a minimum of eye medications.
“For me, her experience emphasizes the importance of that yearly eye exam, especially with patients who have an underlying medical condition. Because I know this patient’s history, I can observe her year to year and make sure we protect her precious eyesight!”
Dr. Mark Bronstein, M.D.
Last Reviewed: October, 2006