Don’t ignore dry eyes.  It could be a sign of thyroid disorder and Meibomian Gland Dysfunction.

 

About 30% of Indians suffer from thyroid disorders, of which Auto-Immune Thyroid Disease (AITD) is increasingly a common problem. AITD is a broad spectrum disease, ranging from Hashimoto’s Thyroiditis to Graves Disease. Hashimoto’s Thyroiditis results in low thyroid hormone production, while Graves disease causes high thyroid hormone production. Women of middle age are most commonly affected. In these diseases, immune cells produce antibodies ( anti-thyroid antibody ) against the thyroid cells, which subsequently damage the gland, since this condition can cause hypo or hyperthyroidism, weight gain or loss can occur.

 

Recent research suggests that AITD is triggered due to long-standing Vitamin D deficiency. Indians are particularly susceptible to Vitamin D deficiency because of darker skin color that reduces the efficiency of indigenous Vitamin D production in the skin.

 

 Patients with AITD often present with changes in eyes. As high as 96% of patients suffering from AITD present with the complaint of dry eyes, as unfortunately the antibodies that harm the thyroid also effect the lacrimal gland resulting in a lowered amount of tear production, which gradually results in dry eyes. Further, eyelid retraction can occur in hyperthyroid patients, causing difficulty in complete closure of eye (incomplete blink). This condition is called Lagophthalmous, in which the exposed eye gradually dries up and can result in ulceration or infection of the exposed cornea. These antibodies also cause inflammation, damage and blockage of meibomian glands of the eyelids. Meibomian glands produce an oily layer over the tear film and protect the tear film from drying up, and thus overall damage to lacrimal gland and meibomian gland result in dryness and irritation of eyes along with swelling of eyelids.

 

 Consultation and treatment by an Endocrinologist are needed for bringing the thyroid hormone to normal levels. However, normalizing the hormone does not alleviate dryness or irritation of the eyes, and thus a thorough eye examination by an Ophthalmologist is needed to evaluate the damage over eyes and eyelids.

 

Dryness of the eyes is usually tested and treated with simple lubricating eye drops. However, often the blockage of the meibomian glands is not entirely resolved. A thorough evaluation of the structural and functional status of meiobian gland is needed, and this can be evaluated through Lipiview Interferometry Technology. The machine measures the blink rate (complete and incomplete blink) of the eyelid, oily layer thickness and detailed HD view of normal and damaged meibomian glands.

 

Recent technological advancements in Ophthalmology have addressed this problem through a non-medicinal approach. Lipiflow is a machine that delivers a thermal pulsation treatment to the meibomian glands, and the gentle synchronized thermal pulsation over the inner and outer eyelid effectively relieves the blockage of meibomian glands, allowing them to function properly and produce protective oils over the eye surface-

Dr. Bhanu Prakash Metukul, M.S, FICO, Fellow (Cornea), FAICO (Refractive Surgery)Senior Consultant Maxivision Super Specialty Eye Hospitals