Hold control (command on a Mac) and press the + key as many times as necessary to increase the font size.
Hold control (command on a Mac) and press the - key to reduce the font size. - hide

Glaucoma and Graves' Disease



James C. Orcutt, M.D., Ph.D.

Elevated eye pressure is extremely common in patients with Graves’ eye disease. However, this does not necessarily mean that glaucoma is also common in Graves’ disease.

Glaucoma is elevation of pressure within the eye which eventually leads to diminution of side vision and damage to the sight nerve which can be seen by the ophthalmologist when he looks in the eye. Elevation of eye pressure alone is therefore not sufficient to make a diagnosis of glaucoma.

On the other hand, eye pressure is commonly elevated in patients with Graves’ disease because of the swelling to the eye muscles and tissues behind the eye. When a patient with Graves’ disease moves their eyes, the stiff muscles behind the eye squeeze against the eye, causing the eye pressure to increase. Fortunately, when most patients with Graves disease look downward, the eye pressure is totally normal. Therefore, most patients with Graves’ disease have only an eye movement elevation of their eye pressure. If the eye is held in this position in which the pressure is elevated, the pressure will rapidly return to a normal level. In addition, most patients with these stiff eye muscles tend to hold their eyes in downward position with their chin slightly forward. So the pressure increase of Graves’ disease is temporary and does not lead to either side vision loss or to damage to the sight nerve.

While it is certainly true that there must be a rare patient who has true glaucoma and Graves’ disease, this is actually very uncommon. The elevated eye pressure can lead to a misdiagnosis of glaucoma in many patients with Graves’ disease. A worrisome problem which this creates is that a misdiagnosis of glaucoma leads to inappropriate treatment if a patient should be losing vision from their Graves’ disease and not glaucoma. Periodic visits to your ophthalmologist should be able to guard against a misdiagnosis.

Used with permission of the author:
James C. Orcutt, M.D., Ph.D., Associate Professor of Ophthalmology, University of Washington (1991)

Download as a PDF.

Recent News

Recent Forum Posts

  • 20 years post RAI, suddenly hyper on same dose Syn

    April 8, 2021, 12:26 p.m.

    Hello and welcome - as you noted, patients do often need tweaks in dosage as they age. Another thought is...

  • Graves Disease and Radioactive Iodine Treatment

    April 7, 2021, 1:36 p.m.

    That's Great Samantha. Good Luck with school!

  • New TED diagnosis

    April 7, 2021, 1:22 p.m.

    Are they treating your thyroid? TED doesn't just happen by itself. It's usually related to issues such as...

  • 20 years post RAI, suddenly hyper on same dose Syn

    April 7, 2021, 1:18 p.m.

    Graves diagnosis 1997, age 37, tx RAI. After adjustment period, Synthroid level stable with brief periods of...

  • New TED diagnosis

    April 1, 2021, 10:48 a.m.

    Just a note that this is very individual. The GDATF hosted a recent webinar on long-term use of antithyroid...

  • New TED diagnosis

    March 31, 2021, 1:43 p.m.

    You still have a thyroid which could at any time randomly chug out more hormone, or less, overriding the...

  • Graves and glucose

    March 31, 2021, 2:20 a.m.

    Hi Kimberly, When I was first diagnosed with hyperthyroidism my fasting glucose was a bit on the high side...

  • New TED diagnosis

    March 30, 2021, 8:28 p.m.

    Thank you so much for your response. I have had a recent CT scan of the orbits which found increased orbital...

  • Graves and glucose

    March 23, 2021, 3:20 p.m.

    Hello and welcome - Graves' disease (and all that comes with it) is definitely overwhelming. The key for now...

  • TED not getting better

    March 21, 2021, 9:36 a.m.

    Thank you all for the advice and kind words. A doctor did mention Tepezza to me, however they didn't think I...

  • TED not getting better

    March 21, 2021, 3:48 a.m.

    Tepezza, which is given as a series of infusions, does work. I have a friend whose TED course has been very...

  • Graves and glucose

    March 20, 2021, 9:40 a.m.

    Hi everyone, I’m new here. To give you some quick background - I was diagnosed with Graves following 2...

  • New TED diagnosis

    March 20, 2021, 4:03 a.m.

    You will need to be followed by an oculoplastic surgeon familiar with Graves. At each visit, pressures should...

  • New TED diagnosis

    March 19, 2021, 7:34 p.m.

    Hello and welcome - hopefully, you will get some responses here, but you might also check out our Facebook...

  • New TED diagnosis

    March 17, 2021, 1:45 p.m.

    Recently diagnosed with early stages of TED. Doctor advised Selenium, low sodium diet, sleeping head...

Questions? Problems? Please contact us at [email protected] or 877-643-3123.

GDATF on Facebook

Support the GDATF and become a member today!

© 2021 Graves' Disease & Thyroid Foundation