Double Vision

[Mprincip]

Has anyone experienced double vision due to Graves Disease? I have seen numerous Drs. I purchased prism glasses but does anybody know of anything else I can do to elevate the vision problem. Any eye excersises or vitamins. I had the plugs put in my eyes in April and that’s when the problems started. I don’t know if that is related. My Dr said no . Any help would be appreciated as I would like to avoid surgery TIA

[ling]

Sorry what do u mean by plugs? What are they for?

[Mprincip in reply to ling]

I have plugs in my tear ducts to help not enough tears staying in my eyes

[ling in reply to Mprincip]

Was that to do with the Graves?

[helvella Administrator in reply to ling]

This is a very heavyweight link which includes some disucssion of punctal plugs in the context of Graves:

eyerounds.org/cases/case19.htm

[ling in reply to helvella]

THANK YOU SO MUCH HELVELLA!!

THIS IS A FANTASTIC PIECE.

GOD BLESS YOU : )

[Me2U in reply to Mprincip]

Think this is a treatment for severe dry eyes? Can be a symptom of hypothyrodism

[Greekchick]

Hi Mprincip,

Sorry to hear about this. I would suggest you have your pituitary function checked and possibly a CT scan. I don’t want to frighten you, but my husband had that problem, unrelated to Graves, and he had a pituitary tumour pressing on the optic nerve. It is worth checking out. He had no headaches - just visual disturbances and the double vision. Hope this is helpful and wishing you well.

[Mprincip in reply to Greekchick]

Thank You, did have an MR, everything is good

[Greekchick in reply to Mprincip]

Good news then! Feel better soon.

[asiatic]

I am surprised you needed to purchase prism glasses which can be expensive and may only correct your double vision for a short time as your eyes will probably change. You should have been referred to an opthalmologist experienced in TED who would monitor your eyes and an orthoptist who would give you a stick on prism changing it when necessary. I have needed about 6 changes in the past few years.

I believe eye exercises helped my TED. There are many on line for double vision.

[Mprincip in reply to asiatic]

I saw a neurological optomologist and he suggested the glasses. They were not very expensive due to insurance. Stick on prism was not recommended.

[asiatic in reply to Mprincip]

The adhesive corrective lenses for double vision go up to about 40 dioptres. I needed a 35 but am now down to a 12. I was told that I needed to be below 10 and my eyes stable for about a year before they would recommend having glasses fitted with prisms. I assume therefore that your double vision is mild and hopefully it will not deteriorate. Although TED runs its own course it is important you do not become hypo so I hope your Graves is well controlled. I have replied to ling about the exercises I do

[ling in reply to asiatic]

What sort of eye exercises asiatic?

[asiatic in reply to ling]

I will tell you the eye exercises I did and which I believe helped.

However there is no evidence backing the use of exercise for TED.

My eye muscles became very stiff limiting movement. By doing exercises I at least felt I was proactively doing something.

1. I held my gaze for a few seconds looking up / down / left / right / diagonally. Repeat x 10

2. I rolled my eyes doing figures of eight. Repeated by reversing direction. Repeat x10

3, Holding up a finger a few inches in front of my nose I focused on it for a few secs. then moved my gaze to focus on an object in the distance. Repeat x10.

Finished by vigorously rubbing hands together to produce heat and covering eyes with palms to relax and soothe.

[ling in reply to asiatic]

Thank you asiatic.

[Cape]

Hi,

I have the same problem very severe but i have Hashimoto's , i juice a whole head of celery every night before bed, and it has helped me a lot, the more inflammed or active my Hashimotos is, the more blurry my eyes are and swollen. it also helps to put cold cucumber or half cut potato on them (or ice pack /frozen peas) when they are blurry, you can see immediate improvement ,but you need to keep doing it through out the day. I also have tiny black specs in my vision and the eye muscles are very tired .

[ling in reply to Cape]

Do you have high myopia?

[Ossuryak]

Keep your hydration up, see if that helps. Also look up info on LUTEIN and ZEAXANTHIN both needed for eyes.

[McPammy]

I had this with Hashimotos. My problem was that I was severely hypo and not being treated correctly. I was on T4 Levothyroxine only. Since I have found out I’m not converting very well T4 to T3. I’m now in T3 medication after a battle to get it. Now my eyesight is back to normal along with many other symptoms I had. I had double and blurred vision.

Have you had your thyroid levels checked recently and are they all optimal.

[cabisore]

I have graves and when it first really kicked off I had severe double vision. Couldn't read, watch TV or drive or work. Once the high dosage of carbimazole kicked in and then later things calmed down so I am on a maintenance dosage the double vision reduced to the extent it is only slightly there when I look to the left. I already had high myopia but during this time it got much worse requiring several changes of glasses. I am left with TED and find my eyes dry out easily so have to keep hydrated.

[ZetaHara in reply to cabisore]

Same condition and same medication here, 10mg per day of carbimazole and now the thyroid started to balance. Do i have hope?

Double vision Started with my left eye now i feel i have double vision on both.

It has been 6 months. Pls let me know what to expect

Thank you

[HLAB35]

Selenium is supposed to slow the progress of ophthalmic issues in Graves.... but as I do not have Graves myself it would be worthwhile double checking I have got this right and whether it will be of any benefit.

This is interesting because Selenium is known to help t4 to t3 conversion so good for those of us who take Levo. Also, I believe that you tend to need more Selenium if you are or have been a smoker... This applies to Hashi's as well as Graves disease.

[ling in reply to HLAB35]

Yes in Graves, for mild TED and supplementing to prevent onset of TED.

[Erin60]

I have Graves and have had numerous eye issues, not double vision but blepharitis and some blepospasm . I have had many many punctual plugs over the years and also many medical contact lenses made to cover the entire eye to protect them against dryness etc, I never felt they helped and the contact lenses were unbearable to wear. I use cyclosporine eye drops which have helped to a degree, I also use hylo forte eye drops and xaline night ointment. I take 4 omega 3 a day ( eye health ones by a company called scope eye) I have found these have helped as well. I have ptosis in left eye as a result of Graves and constantly rubbing dry eyes.

I say all this in case dry eye could anything to do with your double vision, maybe and probably not but I thought I’d mention it in case.

[asiatic in reply to Erin60]

Erin, I was interested to read you found cyclosporine eye drops helpful. I used these for a couple of years when my eyes were really bad and found they helped immensely. I am sure many people with dry eyes or TED would benefit. Unfortunately they are expensive and have to be prescribed by an opthalmologist. Certainly in the UK they are not used very often.

[ling in reply to asiatic]

asiatic, could you share more about your eye problems?

Thank you

[asiatic in reply to ling]

Although all the signs were there my eye problems were missed by Endo who diagnosed thyrotoxicosis and did no antibody tests. Only after GP sent me to opthalmologist for double vision and MRI showed TED did an endo finally diagnose Graves. Eyes worsened as I became Hypo. Pressure increased, light sensitive, swollen, painful, gritty, double vision, colour perception changed and eyes couldn't close at night. Was offered steroid infusions but worried about side effects and aware the disease is self limiting I declined. This proved the right decision as shortly after my eyes reached a plateau and slowly began to improve. Treatment consisted of Lacrilube and eye mask at night. Monopost and tiopex drops for pressure. Cyclosporine drops for dry eyes also optive fusion. Cold gel packs and microwave heat mask also helped. Took selenium. Did eye exercises. Wore sunglasses. After 3 years eyes almost back to normal. Still have some double vision.

[ling in reply to asiatic]

Hypo from too much carbimazole?

Was MRI repeated for double vision?

How were your eyes before the TED?

Must say your endos sound like absolute morons. They should not be practising!

Thank you very very much asiatic, for sharing.

[asiatic in reply to ling]

Eyes fine prior to TED.

2nd MRI not necessary.

Hypo from overmedication as Graves antibodies probably changed from Stimulating to blocking

[ling in reply to asiatic]

Thank you very much asiatic.

[Erin60 in reply to asiatic]

Hi, as far as I’m aware in the UK they are prescribed by secondary care and only then prescribed through the GP after ‘letter’ from consultant.

I urge anyone with dry eye/s to get a referral to the eye clinic as their local hospital, go armed with requests to try different approaches and also when one has seen the eye hospital before ending the conversation ask how long before ‘ whatever is given’ results will be seen, then make sure you request there and then an appointment for after that time frame, or ask if these don’t work what next etc etc and could that be included in the letter to the GP so I can try something else if these don’t work.

If anyone is in the uk they are entitled to these if they have a diagnosis and that is key, which a GP is reluctant to give.

Another point: the cyclosporin I have is ikervis and unlike restasis has a preservative in it ! Shocking I know. What I have found to help with the sting is keeping them in the fridge, the eye will adjust to it.

[Fruitandnutcase]

Asiatic’s exercises sound good things t do in general although the jury is out as t whether or not they will help. I definitely think being proactive makes you feel better.

My vision was blurred when my Graves was at its worst. I also used to get a strange vertical double vision - when I watched the credits roll on TV I used to get the full image plus an after image, same when I was reading a book. It wasn’t very nice as I love to read and read a lot, it was worse if I read for a long time. I used to look up and focus a distance away but it didn’t make that much difference.

I know what you mean about your muscles feeling ‘stiff’. I found using artificial tears very frequently throughout the day really helped, I mostly used preservative free drops although if I was out and forgot to take mine with me I would just buy the cheapest I could find to tide me over.

I used an eye bag that I could heat in the microwave and put that over my eyes, that made them more comfortable.

I would say I had the double vision and blurring for a while before I was diagnosed. Eventually after treatment for Graves I went into remission and gradually I realised that my double vision and blurring had stopped too.

I don’t know for sure but maybe could have the punctum plugs removed if you really feel that has made things worse although it shouldn’t have done but if you do that your eyes will go back there being as dry as they were before and that must have been quite bad before they put them in.

I never did more than try to remember to take breaks and look away into the distance, no exercises use my eye bag and constantly put in my eye drops. I have a feeling (but I’m no expert) that thyroid eyes might just run their course.

I always made sure my vitamins B12 and D and folates and ferritin were well up in their ranges. I topped up with a vitamin D spray although now I top up with a D3, K2 and magnesium mix.

When I was taking carbimazole on the advice of my pharmacist I always took 1000mcg slow release vitamin C with zinc. I always took CoQ10.

I eat a lot of oily fish, lots of green vegetables, nuts - Brazil, walnuts, almonds and seeds - sunflower and pumpkin. I avoid junk food and fizzy drinks - I take water and decaf tea and coffee instead and I always made sure I got a lot of rest and decent sleep. I was obsessed with getting enough sleep. Oh and I went totally gluten free about five years ago which was when my treatment finished. I do regular home finger prick blood tests and in that time my thyroid antibodies have plummeted. It may or may not be with being GF but I’m not prepared to try gluten again. I also avoid sugar as much as I can and I’ve never eaten much dairy although I’m not on a dairy free diet.

Good luck with it all ‘thyroid eyes’ as I used to call them are a total pain to live with but with a bit of luck yours will sort themselves out in time.

Should add - if you smoke - stop!

[Catseyes235]

I had horizontal double vision when a squint developed and was given plastic correcting lenses which stuck on the inside of my glasses to correct it but this was also associated with Diplopia where eyeballs are pushed forward. Diplopia also caused very dry eyes and eventually after years of this I had decompression ops on both eyes, removing some of the bone round the eye socket which helped the eyes drop back very successfully plus I needed an op for the squint ( so long ago I can’t remember if the squint op came first.).

One thing which is paramount is to give up smoking if you do smoke. I think I’d have given up much sooner if had known the link with Graves and TED.

You really need to see eye specialists who understand TED though hopefully knowledge has grown and spread in the last 20 years. My regular Royal Eye Hospital just seemed to check and monitor for nearly 2 years but it was when a head eye specialist overheard I had thyroid problems he stepped in and referred me to Moorefields which made such a difference to treatment and outcome.

Hoping you get the treatment you need!

[Knoxtn865]

I'm going thru samething. Only see doubles at night tho. It didn't start till I got my eyes dilated at dr. Every since then vision has been problem. Do the glasses help?

[ling in reply to Knoxtn865]

You probably want to let the opthalmologist know that. And observe if the double vision goes away after how long or remains.

In any case, you might be interested to have a look at this article to see if your double vision is in one or both eyes. If the cause could be due to Graves, you want to get it followed up so it doesn't worsen.

Double Vision (Diplopia)

health.harvard.edu/a_to_z/d...

All the best.

[Knoxtn865 in reply to ling]

Yes it's from graves

[marin5]

My Mother had the problem for years and finally because of being bug eyed, she wore dark glasses for more years! In the end after many many years, they returned to normal. She had Graves!