How to treat bulging eyes caused by hyperthyroidism

When we say hyperthyroidism, we may still not understand what it means, but if I say "goiter", I believe everyone will have an impression. Someone around me suffered from hyperthyroidism. The impression she gave me at the time was that she kept telling me to control my weight and that medication for hyperthyroidism could easily cause obesity. Bulging eyes caused by hyperthyroidism, or "hyperthyroid exophthalmos", is caused by the combined action of multiple factors. So how to treat bulging eyes caused by hyperthyroidism?

"Hyperthyroidism exophthalmos" is also known as "endocrine infiltrative eye disease", "endocrine exophthalmos", "infiltrative exophthalmos", "endocrine infiltrative exophthalmos", etc. It is a complex orbital disease caused by multiple factors, resulting from cell infiltration, edema and connective tissue hyperplasia around the orbit. It primarily affects the extraocular muscles, lacrimal glands, and retroorbital fat. Exophthalmos may be present alone or in combination with diffuse goiter, pretibial myxedema, or a combination of all three in the same patient.

Classification of hyperthyroidism exophthalmos

Benign exophthalmos

One type of eye changes caused by hyperthyroidism is benign exophthalmos, in which the patient's eyeballs bulge out and the eyes stare or show a frightened look.

Malignant exophthalmos

The other is malignant exophthalmos, which can be transformed from benign exophthalmos. Patients with malignant exophthalmos often experience photophobia, tearing, diplopia, decreased vision, eye swelling and pain, stinging, and foreign body sensation.

Western medical knowledge

1. The activity of suppressor T cells decreases and the number of autoreactive T cells increases.

2. The autoimmune process is amplified, activated T lymphocytes proliferate and activate humoral immune responses.

3.TSAb promotes the release of thyroid hormone, leading to hyperthyroidism and the release of thyroid antigens.

4. Activated T lymphocytes enter the orbital connective tissue through the circulation and interaction with cell surface adhesion molecules, and a local humoral immune response occurs.

5. Humoral and cellular immunity mediate the proliferation of retroglomerular fibroblasts, the expression of vascular and endothelial adhesion molecules and intercellular adhesion molecule-1 on fibroblasts, the release of interferon-γ, transferring growth factor-β, interleukin-1α, and tumor necrosis factor, which stimulate fibroblasts to produce glucosaminoglycans and enter the connective tissue matrix. Glucosaminoglycans are hydrophilic and lead to interstitial edema.

6. Lymphokines released by fibroblasts activate the eye-thyroid common antigen, resulting in massive lymphocyte infiltration, fibroblast proliferation, edema of the retroocular perimysium and connective tissue, increased orbital volume, proptosis, and exposure keratopathy.

Knowledge of Traditional Chinese Medicine

According to traditional Chinese medicine, eyes are the orifices of the liver, and exophthalmos is closely related to the liver. Most of them are attributed to liver depression turning into fire, liver fire rising up, phlegm and fire accumulating inside the body, causing the pupils to look like they are glaring. This disease is often caused by the constitution of "deficiency of both Qi and Yin". Qi deficiency cannot promote blood circulation, and blood stagnates in the blood vessels and forms stasis. The stagnant blood stagnates in the liver orifices and causes bulging eyes that are difficult to resolve. There are also patients who have suffered from liver and kidney yin deficiency for a long time and have blurred vision, dry eyes and tearing. Or patients with bulging eyes, drooping eyelids, swollen eyelids and conjunctival edema, which are caused by spleen deficiency and phlegm stagnation.