I am having a problem with my right eye. It is definately bulging a bit. To the best of my knowledge, it thyroid eye disease does not cause blindness, however, surgery may be required to decompress the eye if it bulges too much. For more info, here is a link to the national graves disease foundation: www.ngdf.org

Both my eyes are noticeably bulged which causes a stare look at times and a little puffiness around my right eye in particular. When I wear my contacts occasionally someone will say I look tired due to the puffiness with the right eye. Anyhow, I have a couple eye docs. The oculoplastic ophthalmologist says unless my vision worsens or the optic nerves start getting pinched then I never have to have surgery unless I want it. I do. I can have the decompression surgery which has a 20-30% chance of double vision worsening. Or I can have eyelid surgery to bring them over the eye more so it takes the stare look away. I have to wait until the thyroid levels are normal though. Only my total T3 is still high. The rest are normal. Well the TSH is still low too but it's improving and my endo MD says it'll take awhile for the TSH to come back to normal. Hope this helps. Feel free to ask me more questions. :)

From what the docs have told me it will only lead to blindness if the eye muscles start pinching the optic nerves. If your eyes are bulged u need to have visual field tests done periodically. These check your peripheral vision and show if your optic nerves are fully functioning. If there is discrepancy they may do a CT scan of your eyes (which I had done in Feb). I had a visual field test yesterday and it's a bit worse. I have another one in a month. *sigh* I hope it's not worse or I might need surgery sooner than I thought. It can definitely cause worsened vision, especially worsened double vision. When I tilt my head to the right my vision separates and the double is worsened which is supposedly "classic" with Graves'. Hope this helps.

Once your Graves is under control, and your life gets some balance, at least in my case my eyes mellowed out some. I have found elevating your head at night and an ice pack help with the swelling.

elevating your head and an ice pack reduce the bulging?

"Bulging eyes" or Graves opthalmopathy (GO)is a very interesting and distressing aspect of Graves Disease. Hope this isnt too detailed but its really interesting and understanding the mechanism helps us understand future targets for treatment..

1) What causes the bulging eyes?: Enlargement of the extraocular muscle bodies and expansion of the orbital fatty connective tissues is apparent in patients with Graves Opthalmopathy (GO)
2) The clinical symptoms and signs of GO (The bulging eyes) can be explained mechanically by the discrepancy between the increased volume of the swollen orbital tissues and the fixed volume of the bony orbit.
3) The expanded orbital tissues displace the globe forward and can block venous (blood) outflow from the orbit. These changes along with the local production of cytokines and other mediators of inflammation, result in pain, proptosis (bulging), periorbital edema, conjunctival injection (redness), and chemosis (swelling of the conjunctiva)
4) Who gets it?: Clinical involvement of the eyes develops in 25% to 50% of individuals with Graves disease. Smoking appears to increase the risk of GO. The annual incidence of Graves ophthalmopathy (GO) in women is approximately 16 in 100,000 and in men three in 100,000.
5) 5% of patients with GO have SEVERE ophthalmopathy, including excessive chemosis (swelling of the conjunctiva), proptosis, or even loss of vision.
6) What can be done for serious eye disease other than treating your Graves? : Surgery for GO in severe cases includes transcaruncular approach orbital decompression (can you believe that name) which effectively treats compressive optic neuropathy
7) As the mechanism of Graves ophthalmopathy (GO) becomes clearer, targeted immunomodulating therapy (remicade, humira, enbrel, etc) should allow for successful treatment. Further research should compare new agents to surgery in order to minimize the morbidity associated with any surgical approach.

Dr O.

Thanks for the info Dr. O. It's actually been a bit hard for me to find much info on it. And I haven't known what to ask the docs. This helps some. What "morbidity" are you talking about with the eye surgery--decompression? They are saying it's my only option if the nerves get affected (which my visual field tests are getting slightly worse). He also talked about eye lid surgery but that wouldn't reduce the bulge symptoms (dry eyes, red eyes, etc). So I'm not sure what to do. he said if the nerves are ok I never have to have any surgery unless I want. It's so scary to think about. I saw some pictures of people afterward and they were bruised but it went away. I could handle that. As long as it works and the bruising doesn't last forever. This has been such an emotional thing to deal with.

Absolutely. My eyes used to meet people before I did. After the radioactive iodine knocked out my thyroid, I had bilateral orbital decompression surgery, which is basically opening the orbits up in the back of the skull so that they eyes can naturally sink back. I was lucky and my vision wasn't affected but it can cause double vision but rarely blindness. After all that settled I had 8 surgeries to correct the eyelid retraction (my eyelids were stuck back into my skull) in both my top eyelids. I have numerous photos of each operation and would be happy to e-mail them to you if it helps.

if they catch your graves, before you have the bulging eyes, and put you on meds, will you still get them? or will it take the swelling down when your levels are back to normal?

Great ? by Mandi
You can still get the "bulging eyes" after treatment is initiated for Graves but that is unusual.
Dr O.

thanks. I have been on treatment now for 2 weeks. methimazole. One of my eyes is looking a little puffy. Will this go down, once the meds are working fully?

I have not got the bulging eyes yet and hope I don't but I began having double vision. Once I would put my glasses on though I could see ok until my eyes got tired. Was prescribed lenses with prism in them which has helped but that has ruined my close vision without glasses on. My doctor never told me that my eyes might be a problem when I was diagnosed with Graves.

Hi,

I have been on treatment for grave's for 8 months, and just this past week my right eye has BULGED out of it's socket.

Before I was diagnosed my right eye was protruding a little bit, but once I started meds it went back to normal.

Now, over this past week I have been dealing with INTENSE personal stress over divorce/custody and my eye looks GARGANTUOUS!..and it's only my right eye so it looks even MORE un-natural!!!

Now that my stress has gotten the best of me....does anyone know if my eye will settle back into place, or once it's "popped" it's popped?

My eyes have been bulging since October 2006. The Doctors swear that 90 % of Graves patients eyes will go back to normal. However it may take 1 year, year and a half or even 2 years. The decision is, how long can one wait or should one wait? Based on the look of the eyes, discomfort and possible damage to our optic nerve is all a part of the decision process. In my case, my eye glasses hide most of the swelling, I've become use to most of the discomforts caused by bright lights and the sun and the many promises made to see my ophthalmologist and family as soon as, if I experience double vision. So, not to bore you any longer, I choose to wait. Problems with my hyperthyroidism is up for another discussion. Thanks for listening.

That's what my Endo said, if they get your Graves under control before your eyes are affected, which not everyone's are. There is a much less chance of developing TED or GO, even after RAI. Very unusual. Thanks Dr. O.
M~