Watch out, goiter can also cause the eyes to swell too & bull; hello healthy

A typical goiter (goitre) with a large lump in the throat caused by disorders of the thyroid gland. It turns out that in addition to causing lumps in the neck, people with goiter also often experience eye problems due to excessive thyroid hormone production, a sign of Graves' disease. Check out the full explanation in the article below.

What is Graves' disease?

Graves' disease is an autoimmune disease in which the body's immune system turns to attack healthy tissue - not foreign cells that cause disease, such as viruses or bacteria. In this case, the immune system attacks the thyroid gland located in the neck, causing the neck to swell, which is characteristic of a goiter. That's why people who have goiter also tend to be more at risk of developing this disease.

Not only does it attack the thyroid gland in the neck, the immune system can also attack the muscles and fatty tissue around the eyes, causing swelling of the eyes.

What are the characteristic signs and symptoms of a goiter that has attacked the eye?

The system attacks causing inflammation that can increase pressure on the eyeball. In some patients, this can compress the nerves of the eye. The swelling and inflammation that occurs also weakens the function of the muscles that move the eyes, called extraocular muscles.

The symptoms of eye disease that are characterized by goiter due to Graves' disease vary depending on the severity. The following is a sequence of symptoms that may arise, in order from the mildest to the most severe degrees of severity:

• Swollen eyelids
• Eyelid retraction (the eyelid is pulled back), can be accompanied or without the protrusion of the eyeball (proptosis) and minimal disturbance of the movement of the eye muscles
• The movement of the eyeball is so disturbed that it causes double vision; protrusion of the eyeball can also be seen clearly.
• Vision can be lost as a result of wound infection in the cornea and pressure on the nerves of the eye.

What checks need to be done?

There are at least three tests that must be done to confirm a diagnosis of Graves' disease, namely:

• Eye examination to look for eye abnormalities in the form of lid retraction, protrusion of the eyeball, eye movement disorders, corneal ulcers.
• Thyroid hormone function tests. Ninety percent of them will show hyperthyroidism, while 5-10% of them can occur in patients with hypothyroidism (the most common cause is Hashimoto's thyroiditis) or euthyroid patients (normal thyroid hormone levels).
• Imaging examinations using ultrasound waves, CT-scan, or MRI. A CT scan of the eye area is the main choice to see thickening of the eyeball muscles, while MRI is used to determine compression on the eyeball nerves.

What is the best treatment for an existing eye disorder?

Treatment varies depending on the severity of the disease being experienced.

If the degree of severity is mild, the treatment is to reduce dry eye conditions by using eye drops. Botox injections of the retracted eyelid may also be recommended. Selenium supplements are prescribed to ward off oxidative stress in the eyes.

In moderate cases, doctors can give methylprednisolone intravenously for one week for 6 weeks. This method has been shown to be effective in reducing the severity of the disease.

For cases that are already severe, treatment needs to be done quickly including administration of corticosteroids, radiotherapy, and also surgical decompression.

How to prevent eye irritation from getting worse

Avoid secondhand smoke, don't smoke or quit smoking if you have been smoking. The increase in the severity of this disease is mainly related to the use of cigarettes. In a recent study comparing smokers and non-smokers, it was found that smoking increased disease severity by up to seven times. In addition, the more cigarettes consumed in one day, the more rapid the disease progression.