ThyroidDisease and Cataracts

[Vernonwendy]

Has anyone had any experience with developing cataracts and is there a potential link to thyroid disease? My ophthalmologist has told me my thyroid eye disease makes me a poor surgical candidate.and getting a second opinion is pretty much out of the question. I am 61 and an active sewer and the prospect of losing my sight is terrifying. Do any other thyroid patients have experience with this?

[waveylines]

What sort of thyroid disease do you have?

I've not heard of hypothyroidism being contrary indicated for cataract surgery.

[Vernonwendy in reply to waveylines]

I have had multiple episodes of viral thyroiditis and eventually my thyroid just packed it in. So I am on comboT3/T4 therapy for the last 6 years. I also have thyroid eye disease.

[waveylines in reply to Vernonwendy]

I wondered if it is Ted. I looked it up and cataract surgery. What it said was it may mean you will need refraction because they can't be as accurate with the lens replacement but nothing about not having the surgery at all.. Of course you'd need to consult your eye specialist.

[Jeppy in reply to Vernonwendy]

May i ask symptoms of thyroid eye?

I had cataracts quite young

[Fruitandnutcase]

Think the problem is that TED is caused by inflammation and inflammation can happen anyway after cataract operations.

Hopefully someone who has had both TED and a cataract operation can come along and help you.

[RedApple Administrator]

There is a paper from 2021 about this:

Risk of Refractive Prediction Error After Cataract Surgery in Patients with Thyroid Eye Disease

Conclusion

Patients with TED are at increased risk for refractive prediction error following cataract surgery. Discussion with patients regarding their risk and possible need for glasses following surgery is important for setting realistic patient expectations.

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

[Vernonwendy in reply to RedApple]

Thanks for posting that. This must be what the Dr isreferring to by a poor outcome.

[waveylines in reply to RedApple]

Yes that's the paper I was looking at. Thanks Red Apple. 😊

[Allergy in reply to RedApple]

Hi I have cataract I’m scared I’m 76 I have put off going

[RedApple Administrator in reply to Allergy]

Allergy 'I’m scared I’m 76 I have put off going'

Do you have thyroid eye disease?

[Allergy in reply to RedApple]

Hi my thyroid has shrivelled to nothing iv started a year ago alway had a fear of eyes I’ve been quite I’ll had no med in total about 8 months

[RedApple Administrator in reply to Allergy]

Lots of people have cataracts by the time they are your age. I completely understand that having an operation on your eye is very scary. But by far the majority of cataract operations are successful. Don't be put off, it's so worth it to get your sight back. Maybe ask about having it done under sedation.

[Allergy in reply to RedApple]

Hi I definitely wouldn’t be awake 🤣

[Nanaofblib in reply to Allergy]

Believe me, it is completely painless, and you don't feel anything, had mine done about 6 wks ago, got fantastic eye sight now, don't need glasses for driving, well worth it.😁

[Allergy in reply to Nanaofblib]

Thank you x

[FancyPants54 in reply to RedApple]

My mum had a cataract operation in the early summer. She was 88 at the time. She was so looking forward to seeing her embroidery better and not having to make her Kindle text big all the time.

She sailed it. No sedation needed. She had nothing but praise for the clinical staff. She was out in a couple of hours. I put the drops in for her because her hands are arthritic. She's not looked back. It was a bit blurry for a couple of weeks, to be expected. But now she's back to embroidery without a struggle and reading actual books where the print is normal sized. She had a new pair of glasses afterwards.

It really is not something to worry about but to embrace.

[RedApple Administrator in reply to FancyPants54]

FancyPants54, Thanks for posting such a reassuring account for anyone whose worried about having a cataract op.

Allergy

[Agitator23 in reply to RedApple]

Hi AllergyDon't be scared. I've had one cataract surgery and am hoping to have another soon. I'm 60. The outcome was excellent. Everything is so clear and the colours are beautiful again! It was a straightforward procedure and quick and painless. It was a game-changer for me. Good luck!

[Lellu in reply to Allergy]

Hi I had op done on both eyes, no need to worry. Your eyes are added drops so you do not feel anything, you are awake with eyes open, but believe me you don’t feel anything and your eye side is excellent

[goiter]

Hi, I don't know if this will help but earlier this year (2023) I had cataracts removed from both eyes. I also suffer from Thyroid nodules and Goitre. As I am in the UK and our medical system is"broken" I am waiting to see an Endocrinologist to have some proper tests done to determine what is going on with my Thyroid. I had this problem before I went for my cataract operations and no one asked me about my thyroid. I don't think it can be relevant but I'm not a doctor. If I were in your position I would do some research using YouTube. There are many doctors and hospitals posting there. My cataracts ops were fine and I can see perfectly well now. I am 78. Good luck and don't give up. Blessings of love and light to you.

[Vernonwendy in reply to goiter]

Thank you so much! I will do a deep dive for more info.

[Star13]

I just had right eye cataract surgery two weeks ago and Im 72. I was warned about all the different bad outcomes and issues that could happen which is part of the risk factors of cataract surgery. However my surgeon was also very clear that as I’d had previous surgery for raised pressure plus I was on anticoagulants, together with my autoimmune background, it was possible that I could have issues but he hoped obviously not. It certainly wasn’t a reason NOT to have surgery.

Well the surgery took an hour and a half and let’s just say it was complex due to hitting complications, I had to have stitches, however with the excellent skill of my surgeon, so far so good!

Things are improving slowly and today he stopped the antibiotic drops and introduced some anti inflammatory drops to go with the steroids and it’s made a big difference.

He said it’s probable that the other eye will be just as difficult however he isn’t put off and nor will I be when the time comes. My advice is to find a good eye surgeon who deals with difficult surgeries- glaucoma patients, old people, etc not those who churn them out on a conveyor belt. Someone who is used to dealing with people with compromised immune systems as mine is.

[Vernonwendy in reply to Star13]

Well there you go! I am also on blood thinners due to A Fib and have had previous eye surgery. I also have the thyroid eye disease and very dry eyes. I suspect I need to see if I can look for a surgeon more skilled with difficult cases. Your comments are giving me hope.

[FancyPants54 in reply to Vernonwendy]

Mum's surgery at age 88, with all sorts of medical issues and vision problems, just sailed through with the normal "conveyor belt" surgeon. He was lovely, very kind and reassuring to her and the outcome was great. It's a simple operation as operations go. You don't need an extra layer of special specialist. They are all specialists in eye surgery otherwise they wouldn't be doing it. You just need to get it done. Don't worry. On the way home from the hospital mum and I went for a coffee and a look around a shop. Her sight is so much better now.

[catay in reply to FancyPants54]

Hi, This is my first post on the forum. I am Diogenes daughter and fell onto the forum looking at the lovely comments about him after his passing a few weeks ago. The only reason i thought i would post is because, whilst I'm now retired ,my background was as an Optometrist and I was qualified in both pre surgical work up and post surgical cataract review. I was therefore reading the posts regarding thyroid disease and cataract surgery with some interest. There really isn't a quick answer to the original question ,I'm afraid. The risks associated with cataract surgery (as with all eye surgery) are many and varied and are entirely and necessarily very patient specific. The experiences of individuals are nice to read about but unfortunately don't necessarily translate to being of use for the original poster of the question. Certainly living with a thyroid condition in itself isn't a contraindication to cataract surgery. However there are some symptoms and signs that some thyroid suffers have that most definitely are. For example the refractive surprise element often comes with Graves disease and patients having additional bulk of tissue surrounding the eyeball. This changes the shape of the eyeball and makes selecting a replacement lens more difficult. Refractive surprise in itself may not be much of an issue as long as its not too great. However it can be enormously problematic if one eye ends up with a radically different prescription spectacle lens from the other eye. Not all thyroid patients have the additional bulk though. In fact most don't.

There can be an inflammatory element to thyroid eye disease that, again ,some will have but most wont. If there is inflammation in and around the eye tissue then there are significant risks of surgical intervention setting off an unwanted inflammatory response. All cataract surgery tends to do this to a greater or lesser extent anyway. This can, in some cases, be a significant problem and maybe difficult in some cases to settle down. If there is inflammation of the macula region within the eye then there can be a risk of sight loss. Not common but is a risk of all cataract surgery on anyone but made riskier with inflammation already present.

Then there is dry eye. Again not all thyroid patients have this, but some do. Cataract surgery in all patients reduces the innervation to the system that produces the tear film that covers the eye. One of the side affects for all cataract surgery therefore being induced dry eye. So if ,as a thyroid patient, there is already significant dry eye (poor tear film) then this could be worsened and the risk of this is creating a lot of discomfort and potential problems with desiccation to the cornea. That is a problem because it will damage the sight too.

So my main point here really is that every patient with cataracts is absolutely unique in terms of their eye history and their medical history and whist in the main cataract surgery is very common and in most people fairly routine there are a whole spectrum of variables that need to be considered on an absolutely individual basis. I have tried to explain the things that may or, may not be relevant , to someone with thyroid disease.

My final point is around Ophthalmologists and their expertise. Not all Ophthalmologists will do cataract surgery. They will be qualified to do it but these days Ophthalmologists tend to specialise in different parts of the eye e.g. anterior/posterior/squint surgery etc. Basically because the work is so complex and it's best to gain real in depth skill in select areas. So all are not necessarily as experienced in one procedure as another. That said they usually consult one another for their colleagues expertise when needed. They are really experts within an expert field. So it maybe wise for you to ask a second opinion of an Ophthalmologist who specialises in anterior eye surgical procedures.

I hope all this rambling is of some help!

[RedApple Administrator in reply to catay]

catay, Welcome to the forum. Thank you so much for taking the time to post this. It is enormously helpful for members to have input from someone qualified.

[Vernonwendy in reply to catay]

Wow! Just Wow! That was so informative and so incredibly helpful!!! I think one of the biggest issues I have is extremely dry eye and I do now understand that the cataract surgery can intensify this. However, I am endeavouring to do all I can to improve the condition of the surface of my eye and feel better informed about my specific risks going into this. Thank you so much for your very informed and helpful input!!

[janeroar]

I’d get a referral to Moorfields. Probably still the best eye hospital in the world. As someone already suggested have a consultation with a really experienced surgeon.

[Brightness14 in reply to janeroar]

Southampton always had an Eye Hospital now it is part of the Main Hospital. I had my eye operated there they are experts in the field.

If you live near London Moorfields is considered the best.

[FancyPants54 in reply to janeroar]

You are really over-egging the cake here! This is not a complex case for a surgeon. Any hospital eye department will be just fine. Stop scaring the already scared patient. There's no need for the best eye hospital in the world. They probably wouldn't even consider the referral. Our experience was with bog-standard Northampton hospital, a rabbit warren of old hospital complex. The place is barely holding together as a structure but mum's care was great. The operation over very quickly and the recovery easy. She was so pleased to have it done. She has all sorts of medical issues. There was no problem at all.

[janeroar in reply to FancyPants54]

I suggested a specialist as my brother in law had cataracts operation that went wrong because he wasn’t dealt with by the best person given there was some complexity. I said it for my own reasons too having had numerous eye operations including cataracts. One operation went wrong and I wished I had done my research. Not trying to scare her - giving my own opinion. I’m glad your experience of NHS has been good. Unfortunately as many on here will testify that’s not the case for everyone. Better safe than sorry.

[FancyPants54 in reply to janeroar]

But it is the case for most. It's usually a simple operation, even for those who are elderly or unwell with other conditions. We can't all expect to see the top docs for everything. We should be thankful we can get such treatment easily. This person has no need to worry. But is already worried so conversations like this won't help.

[Star13 in reply to FancyPants54]

Unfortunately not everyone’s experiences are the same. My 84 year old step mother just sailed through both her eyes being done with 15 minute ops. I went in expecting the same but didn’t get it unfortunately but was extremely grateful for the skill of a good surgeon. My issue was caused by the fact I’d had previous surgery so I think it is better for someone who has a complicated eye history to be more cautious and do more homework. That’s not scaring anyone just being realistic.

[Levo1]

Cataracts are extremely common as one gets older and happen very gradually. Surgery is extremely successful so there is no need to be terrified about losing sight. I’m not sure if the occurrence amongst those with hypo is any greater than those without. Hope that puts your mind at rest a little.

[Mozzymoo22]

I am hypothyroid and I developed cataracts in my early 50s. They were operated on with no problems. I have never looked back

[Jeppy in reply to Mozzymoo22]

I too was 50 i was hypo. Sub clinical Do you think its related ive thought so since the ops

One was 'stubborn it took 50 mins the other 30

[Marion_63]

I have had cataract surgery on both my eyes this year ( March and June ). My cateracts were progressing quite qiuckly over a couple of years. I have an underactive thyroid and it was my optician that referred me for the surgery. I sew a lot and do a lot of embroidery and soft crafting and would be lost without my sight. I am 69 years old. Hope this helps. 💓

[Italiangirl123]

I was diagnosed with TED in 2009 and had cataract surgery on both eyes in 2015 with an excellent outcome to the extent that at the age of 77 I no longer need specs of any kind. I did extensive research and was fortunate to get an NHS referral to the Centre for Sight at East Grinstead. I was operated on by the founder (not naming him but can easily be found online) using the femtosecond laser as opposed to traditional surgery and you might wish to research this too. As it happens I am currently under the care of Moorfields for an unrelated condition and can’t recommend them highly enough. I believe that they too do cataract surgery using the femtosecond laser so if it’s feasible for you a second opinion from them would be worth considering.

[Vernonwendy in reply to Italiangirl123]

Now this is the info I was seeking! I understand the cataract surgery itself is straightforward, but it’s the TED that complicates it and not all with thyroid issues have TED. I am very happy to hear you had a very positive outcome and thank you for naming the type of procedure. I am in Canada and I think our healthcare system is a fair bit behind yours in the UK but I will see if my surgeon uses this method for difficult cases. Thank you again!

[Daisywhoopsa]

I have Hashimotos and acute open angle glaucoma in both eyes as well as cataracts in both eyes. I have had surgery to one eye previously to help with pressure - a trabeculectomy. On 2nd Jan I am having the first cataract surgery and the other on 30th Jan after a routine consultation on 14th Dec. . I don’t have TED. I attend Moorfields for all my eye related treatments even though it means a 3hr journey each way. I have always been impressed at just how good all the clinicians there are. It’s the best place in my opinion so if you can be referred there I’m sure you’ll be well looked after. Because of the very nature of eye matters they don’t seem to make you wait long for consultation or treatment either.

[Fernsmum]

Hello Vernonwendy , yes I've had a thyroid problem for years and developed a cataract in both eyes my thyroid eye they told me is really not worth doing as sight too damaged but , my other eye has now been done and I only now need specs for reading ,before my percription glasses were very strong , so I think it might be worth speaking to the pros and then make a decision . Good luck

[Carri3]

I have cataracts and I began using castor oil eye drops a few weeks ago as they are recommended for dissolving cataracts, and to prevent dry eyes. I haven't had dry eyes since I began using them and no longer have pain behind my eyes from strain so hopefully they're dissolving the cateracts too. There's a lot of useful info about castor oil on You Tube.

[Vernonwendy in reply to Carri3]

The idea of putting castor oil in my eyes is rather unnerving, I have to say. But I am so happy it’s working for you!!

[Carole-J]

Hi I have had underactive thyroid for quite a few years now along with Sjogrens disease and Antiphospholipid syndrome. I have had cataract surgery on both eyes and it was successful and I can see beautiful colours and I am able to read again. The surgery is completely painfree and I would do it again if it was nessessary. I am 76 years old.

[Vernonwendy in reply to Carole-J]

Thanks for your reply. I am definitely feeling encouraged that I won’t have to say goodbye to my sight anytime soon. I am 61 and an avid sewer and knitter. It would feel pretty devastating.

[GS61]

hi, I have had thyroid eye disease back in my 30’s, had Graves and total thyroidectomy. I’m now hypo, 63 and had cataracts removed and lens replacement surgery 3 years ago with no issue.