Thyroid eye disease, or Graves disease may cause “bulging” eyes and double vision. The disease is more prominent in females than males and includes former First Lady and current “First Grandmother” Barbara Bush.

Thyroid eye disease is an immune system disorder, or body inflammation, that may result in minor or significant changes in the appearance and function of the eyes. The exact cause is incompletely understood. However, current research suggests that the bodys’ immune system creates an abnormal protein that acts like a key to either open or lock the production of thyroid hormone. The signs of over production of thyroid hormone include goiter, weight loss, nervousness, fast heartbeat, heat intolerance, fine hair, diarrhea and leg swelling. The signs of under production of thyroid hormone include fatigue, slow heartbeat, constipation and weight gain.,

This same abnormal immune system protein altering thyroid function may attack the soft tissues and muscles surrounding the eyes. The subsequent inflammation and scarring of the tissues surrounding the eyes accounts for the characteristic eye signs of Graves disease including the following: stare, bulging eyes (proptosis), eyelid retraction, eyelid swelling, upper eyelid lag with down gaze, and in extreme cases, globe capture or blindness.,

Graves disease is confusing in that the eye problems may occur independent of thyroid involvement. In fact, 20% of patients never develop thyroid problems, about 45% show low thyroid production and another 20% will show eye findings before any thyroid dysfunction. The course of the disease may vary from mild eyelid swelling to progressive blindness. The length of Graves related inflammation has tremendous variability, but typically subsides over a two year period.