Thyroid Diseases Require Careful Eye Examination

Thyroid diseases can have a negative effect on the eyes as well as on many organs in the body. Underlining those serious eye problems that may cause permanent loss of vision may be encountered if untreated, the Ophthalmology experts underlined that eye examinations should not be missed, especially after surgery.

Diseases involving the thyroid gland can be accompanied by problems such as sweating, palpitations, nervousness, and hair loss caused by an increase in thyroid hormone levels in the blood or enlargement of the eyeballs, damage, and infection due to compression of the optic nerve, decreased vision, impaired eye movements, and double vision. Although this condition is usually controlled with medication, in patients who do not respond to medication, the disease can be controlled by surgical removal of all or part of the thyroid gland.

It is necessary to pay attention to the changes that occur in the eyes after total thyroidectomy, that is, surgeries performed due to thyroid-related diseases or thyroid gland tumors, in which the thyroid gland is completely removed. Yeditepe University Hospitals Ophthalmology Specialist stated that the most important determining factor in eye problems that may occur after thyroid surgery is the duration of low calcium levels due to parathormone insufficiency, pointed out that cataracts develop rarely in cases where these problems are temporary, and more frequently in cases lasting longer than 6 months. In addition to these, the expert stated that the patient's advanced age, the presence of cataracts, and smoking accelerate the emergence of these problems, "If the patient has diseases that facilitate the formation of cataracts such as diabetes, kidney disease or has a disease that requires long-term steroid use, eye-related problems may occur earlier."

Eyes Should be Carefully Examined

Underlining that eye problems do not occur after every thyroidectomy surgery, experts stated that cataract develops in approximately 60 percent of patients with prolonged low calcium in the blood after surgery. Reminding that cataract findings can be detected with a careful eye examination in patients undergoing thyroidectomy surgery, experts continued their words as follows: "The most important point in these patients is to determine the low levels of parathormone and calcium that exist in the patient but have not yet been detected by eye examination. Because these cataracts do not cause any complaints at the initial stage and can be easily overlooked. The effects of cataracts on vision are monitored by a specialist ophthalmologist and surgery is recommended to correct vision in patients with progressive cataracts. We, ophthalmologists, can detect cataract findings with a careful eye examination in patients who have undergone thyroidectomy surgery. The most important point in these patients is to determine the low levels of parathormone and calcium that are present in the patient but not yet detected. Because calcium deficiency can cause fatal rhythm disturbances in the heart and cause sudden loss of life unexpectedly."

"Thyroid Surgery Has No Direct Effect on the Eye"

Stating that removal of the thyroid gland does not have any direct effect on the eye, experts stated, "This surgery is an effective surgical method widely used all over the world to stop the progression of eye-related problems, which can lead to enlargement of the eyes and even loss of vision in patients with Graves' disease." Underlining that the eye problems that may occur after goiter surgery are mostly related to the decreasing blood parathormone level due to temporary damage or removal of the parathyroid glands located behind the thyroid gland, giving the following information: "Parathormone, whose blood level decreases, causes a decrease in the level of calcium in the blood. If the decrease in blood calcium level continues for a long time, deposits are formed in the lens tissue of the eye. Over time, these deposits increase, resulting in the development of cataracts in the eyes and decreased vision. Low calcium levels in the blood may cause tingling in the hands and feet, muscle cramps, stiffness in the muscles, twitching in the facial muscles, numbness around the mouth, and headache."

Eyelid Ptosis is Rarely Experienced

Yeditepe University Ophthalmologists reminded that very rarely, eyelid ptosis and shrinkage of the pupil can also be observed after thyroid gland surgery and added: "Especially in thyroid tumor surgeries where the lymph nodes in the neck should be removed together with the thyroid gland, damage to the neck nerves during surgery, compression of the neck nerves due to blood accumulation, which we call hematoma, can lead to this problem, which does not cause problems with vision, causes more cosmetic problems. This problem can be corrected by surgery at the appropriate time."

Are the Problems Reversible?

Cataracts that develop in the eye do not cause any complaints in the initial stages, but in cases where low calcium persists, cataracts progress and cause a decrease in the level of vision. Stating that this decrease in the level of vision negatively affects the life of the person over time, experts stated, "This situation can only be corrected by cataract surgery in which the cataract is removed and replaced with an artificial lens. There is no treatment for this visual impairment with medication or drops other than surgery."

Apart from these, experts explained that sudden loss of vision after thyroid surgery is not an expected situation and stated, "I recommend that our patients who notice sudden changes in their vision after such surgeries should not wait at all and consult an ophthalmologist as soon as possible."