Thyroid diseases can have a negative effect on the eyes, like many organs in the body. Emphasizing that serious eye problems may be encountered that may cause permanent vision loss if not treated, Ophthalmology Specialist and Faculty Member Dr. Yasin Özcan underlined that postoperative eye examination should not be disrupted, especially.


Diseases related to the thyroid gland can be accompanied by sweating, palpitations, irritability and hair loss or growth in the eyeballs, damage and inflammation due to compression of the optic nerve, decreased vision, impaired movement of the eyes, and double vision, which are caused by the increase in thyroid hormone levels in the blood. Although this situation is usually controlled with drug therapy, in patients who do not respond to drug therapy, surgical removal of either the whole or a part of the thyroid gland can be controlled.

It is necessary to pay attention to the changes in the eyes after total thyroidectomy, that is, operations in which the thyroid gland is completely removed due to thyroid-related diseases or thyroid gland tumors. Yeditepe University Hospitals Ophthalmology Specialist and Faculty Member Dr. Yasin Özcan claimed 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. He pointed out that in cases where these problems are temporary, they rarely develop, and in cases lasting longer than six months, they develop more frequently. In addition to these, the patient's advanced age, presence of previous cataracts and smoking accelerated the emergence of these problems. Dr. Özcan continued, "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 problems may occur earlier”.



A careful eye examination is required.


Underlining that eye problems do not occur after every thyroidectomy surgery, Dr. Yasin Özcan said that about 60 percent of patients with prolonged low calcium in the blood after surgery developed cataracts. Reminding that cataract findings can be detected with a careful eye examination to be performed in patients who have undergone thyroidectomy surgery, Dr. Özcan continued his words as follows: “The most important point in these patients is to determine the parathormone and low calcium levels that are present in the patient but not yet detected by eye examination. Because these cataracts do not cause any complaints when they are in 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 performed in patients undergoing thyroidectomy. The most important point in these patients is to determine the presence of parathyroid hormone and low calcium levels that have not been detected in the patient with an eye examination. Because calcium deficiency can cause fatal rhythm disturbances in the heart, causing sudden loss of life unexpectedly".



Thyroid surgery has no direct effect on the eyes


Stating that the removal of the thyroid gland has no direct effect on the eye, Dr. Yasin Özcan stated, "This surgery is an effective surgical method that is widely used all over the world in order to stop the progression of eye-related problems that can lead to enlargement and even vision loss in patients with Graves’". Underlining that the eye problems that may occur after goiter surgery are mostly related to the decreased blood parathyroid hormone level due to temporary damage or removal of the parathyroid glands located behind the thyroid gland, he gave the following information: “If the decrease in calcium levels in the blood continues for a long time, deposits form in the lens tissue of the eye. Over time, these deposits increase, resulting in the development of cataracts in the eyes and a decrease in vision. Low levels of calcium in the blood can cause tingling in the hands and feet, muscle cramps, stiffness in the muscles, twitching of the facial muscles, numbness/numbness around the mouth, and headache".



Rarely eyelid drooping is experienced


Reminding that very rarely, eyelid drop, and pupil shrinkage can be observed after thyroid gland surgery, Dr. Yasin Özcan said, “Especially in thyroid tumors, where the thyroid gland and lymph nodes in the neck must be removed, damage to the neck nerves during surgery and compression of the neck nerves due to blood accumulation, which we call hematoma, can cause this problem. This problem, which does not cause problems with vision, causes more cosmetic problems, and this problem can be corrected by surgery to be performed at the appropriate time."



Can the problems that occurred return?


According to the information given by Dr. Özcan, cataracts that develop in the eye do not cause any complaints in the initial periods, but in cases where low calcium continues, cataracts now progress and cause a decrease in vision level. Stating that this decrease in vision level negatively affected the life of the person over time, Dr. Yasin Özcan went on by saying, “This situation can only be corrected by cataract surgery, in which we remove the cataract and replace it with artificial lenses. There is no treatment for this visual impairment with drugs or drops other than surgery".


Stating that the optic nerve is permanently damaged as a result of the inflammation in the optic nerve as a result of the progression of Graves' disease, Dr. Özcan also said that even if the thyroid gland is removed in these patients, there will be no return at the visual level of the patients, only more loss can be prevented from becoming blind. Explaining that sudden vision loss is not an expected situation after thyroid surgery, Dr. Yasin Özcan concluded his words as follows: "I recommend our patients who notice sudden changes in their vision after such surgeries not to wait at all and to consult an ophthalmologist as soon as possible".



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