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Dry Eyes And Thyroid Disorders
Nov 2018
Dr Bhanuprakash
Senior Consultant, MaxiVision Eye Hospital

About 30 per cent Indians suffer from thyroid disorders of which autoimmune thyroid disease (AITD) is increasingly a common problem among the population. AITD is a broad spectrum of disease ranging from Hashimoto’s thyroiditis to Graves’ disease. Hashimoto’s thyroiditis results in low thyroid hormone production, while Graves’ disease causes high thyroid hormone production. In these diseases, immune cells produce antibodies against the thyroid cells which subsequently damage the gland. Since this condition can cause hypo or hyperthyroidism, weight gain or weight loss can occur.

Recent research suggests that AITD is triggered by long-standing vitamin D deficiency. Indians are particularly susceptible to vitamin D deficiency, due to a darker skin colour, which reduces the efficiency of indigenous vitamin D production in the skin.

How The Eyes Are Affected
The patients with AITD often present with changes in their eyes and 96 per cent of patients suffering from AITD complain of dry eyes. Unfortunately, the antibodies that harm the thyroid gland also affects the lacrimal glands which are situated in the orbit of each eye, resulting in a lowered amount of tear production. This gradually results in dry eyes. Moreover, eyelid retraction can occur in hyperthyroid patients causing difficulty in complete closure of eyes (incomplete blink). This condition is called lagophthalmos, whereby the exposed eye gradually dries up and can result in ulceration or infection of the exposed cornea.

These antibodies also cause inflammation, damage and blockage of the meibomian glands of the eyelids. Meibomian glands produce an oily layer over the tear film and protect the tear film from drying up. Thus, overall damage to the lacrimal gland and meibomian gland results in dryness and irritation of the eyes, along with swelling of the eyelids.