Photophobia in a Patient with Hashimoto's Thyroiditis

[helvella]

Another fragment - there might well be several causes and associated illnesses, but likely the thyroid connection has simply been ignored or missed. Or just not followed up at all.

Intern Med. 2018 Oct 1; 57(19): 2919–2920.

Published online 2018 Apr 27. doi: 10.2169/internalmedicine.0178-17

PMCID: PMC6207814

PMID: 29709929

Photophobia in a Patient with Hashimoto's Thyroiditis

Yoshito Nishimura1 and Fumio Otsuka1

Author information Article notes Copyright and License information Disclaimer

A 31-year-old Vietnamese woman presented to our hospital for photophobia. On an examination, right-sided mydriasis with a poor reaction to light (Picture A, arrow) and nontender goiter (Picture B) were noted. No dyshidrosis or areflexia was observed. Positive anti-thyroid peroxidase and thyroglobulin antibodies and diffusely enlarged thyroid goiter that exhibited a heterogenous pattern of the parenchyma by ultrasound (Picture C) led to the diagnosis of Hashimoto thyroiditis with Adie's tonic pupil. Her photophobia gradually resolved with pilocarpine eye-drops. Adie's tonic pupil is an autonomic nervous system disorder characterized by mydriasis with a poor light response. It is 3 times more common in women than in men and is unilateral in 80% of cases. Patients may have areflexia. Infection, malignancy, trauma and granulomatous diseases, such as sarcoidosis, have been suggested to cause the syndrome. Coincidence of Adie's tonic pupil with autoimmune hepatitis, celiac diseases and scleroderma has been reported (1,2). However, there have been no reports regarding autoimmune thyroid disorders and Adie's tonic pupil. Therefore, when encountering a case of photophobia of unknown etiology, the thyroid should be routinely checked.

ncbi.nlm.nih.gov/pmc/articl...

Some information about Adie's tonic pupil:

eyewiki.org/Adie%27s_Tonic_...

[Hidden]

I was recently diagnosed with blepharitis. It's not too bad with using the drops nd wipes, but my eyes tend to hurt in bright light, especially the left one. Could it be connected??? They also seem to be worse if hypo symptoms are worse, or especially if I have to concentrate hard, as when driving or reading a lot, especially on the computer.

[helvella Administrator Thyroid UK in reply to Hidden]

There have been quite a few posts about being unable to cope with oncoming headlamps when hypothyroid.

I never suffered too badly, but the pleasant surprise that after months of levothyroxine, when one evening I realised was back to my normal, was wonderful.

And many years ago I had iritis - three times. That truly made it impossible for me to open my eyes at all. No idea if that had any thyroid element but it was long before I had any idea about thyroid issues.

[Hidden in reply to helvella]

I have slight cataracts which makes night driving difficult anyway. those yellow clip on glasses help to cut down dazzle, but I still avoid night driving when possible

[TSH110 in reply to helvella]

Headlights and lights at night give me really bad problems which I only developed in the late stages of hypothyrodism. I think iritis can be linked, not sure if I read it somewhere. My mother had it quite badly. Yet I neeed very bright light to see properly at night and loathe those energy saving bulbs - absolutely useless. I found some 100watt equivalents - 150 would be even better!

[Pascha1]

I must have photophobia as I cant even go in tescos as lights are to bright, I have dim lighting at home, just bright lights freak me out,, I only have hypothyroid because Sub thyroidectomy,,I haven't got Hashimotos, so must just be Hypothyroid in general, my friend who is hypo also cant handle bright light,, I cant even drive at night as car headlights are to bright.. so stick to day time driving

[Hidden in reply to Pascha1]

That seems likely. I think the article is about a specific kind of eye problem, where the iris doesn't contract normally (too slow) in bright light (is that right helvella ?) But as hypothyroidism affects every part of the body, including tendon reflexes, it might well cause the same problems in the eyes.