Basedow disease
The thyroid gland produces two hormones that contain iodide (Triiodotironine = T3 and Tiroxin = T4). These hormones upregulate general cell metabolism and are essential for a healthy life. When the thyroid gland functions excessively, the blood levels of these hormones are increased to a great extent.
Basedow disease is a type of hyperfunction of the thyroid gland and usually leads to eye disorders. The eye disorder is named endocrine orbitopathy and sometimes occurs without dysfunction of the thyroid gland. Endocrine orbitopathy occurs as an autoimmune disease. In this condition, the immune system produces antibodies against its own body tissues. In this case, it produces antibodies against the thyroid gland and connective tissue in the orbit. The disease is caused by these antibodies. It is observed especially in women aged between 20 and 45 years. In endocrine opthalmopathy, water primarily accumulates in the palpebrae and orbits. Subsequently, adipose tissues increase in accordance to the severity. External eye muscles also enlarge and uptake water.
Overfunction of the thyroid gland may lead to increased metabolism, weight loss despite increased appetite, palpitation, insomnia, shivering, restlessness, sweating and diarrhea. In addition, hair loss occurs. In endocrine ophtalmopathy, the eyes bulge anteriorly (exophtalmos) because of tissue enlargement and water accumulation in the orbits and a sense of pressure occurs behind the eyes, which may occur unilaterally or bilaterally. In addition, the palpebrae and connective tissues expand, lacrimation occurs and bright light gives discomfort. In cases where the upper eye muscles are also involved, the movementes of the eyes are limited and diplopia starts.
In endocrin opthalmopathy, the opthalmologist can determine if the eyes are bulged anteriorly using a special device (exaphtolmometer) with the help of small mirrors and a millimeter measurement stick. The opthalmologist also examines the eye completely and checks eye movements.
The function of the thyroid gland should be normalized to treat this eye disease successfully. Treatment with eye drops is usually sufficient in mild endocrine opthalmopathy. In advanced endocrine opthalmopathy, anti-inflammatory drugs including corticosteroid constitute the standard therapy. Orbital radiation frequently improves the complaints. In advanced stages, orbital surgery is performed. With operation of eye muscles diplopia may be decreased or may be eliminated completely.