Experts say that diseases involving the thyroid gland can progress with sweating, palpitations, irritability and hair loss or growth in the eyeballs, damage and inflammation due to compression of the optic nerve, decreased vision, impaired movement of the eyes, and double vision, which occur with the increase in thyroid hormone levels in the blood. Although this situation is usually controlled with drug therapy, in patients who do not respond to drug therapy, surgical removal of either the whole or a part of the thyroid gland can be controlled.
Noting that it is necessary to pay attention to changes in the eyes after total thyroidectomy, that is, operations in which the thyroid gland is completely removed, due to thyroid-related diseases or thyroid gland tumors, Ophthalmology Specialist Dr. Faculty Member Yasin Özcan said that the most important determining factor in eye problems that may occur after thyroid surgery is the duration of low calcium levels due to parathormone insufficiency.
CATARACT RISK IN CASES LONGER THAN 6 MONTHS
He pointed out that in cases where these problems are temporary, they rarely develop, and in cases lasting longer than 6 months, they develop more frequently. In addition to these, the patient’s advanced age, presence of previous cataracts and smoking accelerated the emergence of these problems, Dr. “If the patient has diseases that facilitate the formation of cataracts such as diabetes, kidney disease, or has a disease that requires steroid use for a long time, eye problems may occur earlier in the period,” said Yasin Özcan, a faculty member.
CAREFUL EYE EXAMINATION IS REQUIRED
Underlining that eye problems do not occur after every thyroidectomy surgery, Dr. Lecturer Ü. Yasin Özcan said that about 60 percent of patients with prolonged low calcium in the blood after surgery developed cataracts. Reminding that cataract findings can be detected with a careful eye examination to be performed in patients who have undergone thyroidectomy surgery. Lecturer Yasin Özcan continued his words as follows:
“The most important point in these patients is to determine the parathyroid hormone and low calcium levels that are present in the patient but not yet detected by eye examination. Because these cataracts do not cause any complaints when they are in the initial stage and can be easily overlooked. The effects of cataracts on vision are monitored by a specialist ophthalmologist, and surgery is recommended to correct vision in patients with progressive cataracts. We, ophthalmologists, can detect cataract findings with a careful eye examination performed in patients undergoing thyroidectomy. The most important point in these patients is to determine the presence of parathyroid hormone and low calcium levels that have not been detected in the patient with eye examination. Because calcium deficiency can cause fatal rhythm disturbances in the heart, causing sudden loss of life unexpectedly. “
“NO DIRECT EFFECT OF THYROID SURGERY”
Stating that the removal of the thyroid gland has no direct effect on the eye, Dr. Lecturer Özcan said, “This surgery is an effective surgical method that is widely used all over the world in order to stop the progression of eye-related problems that can cause eye enlargement and even vision loss in patients with graves.”
Underlining that the eye problems that may occur after goiter surgery are mostly related to the temporary damage or removal of the parathyroid glands located behind the thyroid gland, they are related to the falling blood parathyroid hormone level and gave the following information:
“The lowering of the blood level of the parathormone causes the calcium level in the blood to decrease. If the decrease in calcium levels in the blood continues for a long time, deposits form in the lens tissue of the eye. Over time, these deposits increase, resulting in the development of cataracts in the eyes and a decrease in vision. Low levels of calcium in the blood can cause tingling in the hands and feet, muscle cramps, stiffness in the muscles, twitching of the facial muscles, numbness / numbness around the mouth, and headache. “
Rarely is there eyelid drooping
Reminding that very rarely, eyelid drop and pupil shrinkage can be observed after thyroid gland surgery, Dr. Lecturer Ü. Yasin Özcan said, “Especially in thyroid tumors, where the thyroid gland and lymph nodes in the neck should be removed, damage to the neck nerves during surgery and compression of the neck nerves due to blood accumulation, which we call hematoma, can cause this problem. “This problem, which does not cause problems with vision, causes more cosmetic problems and this problem can be corrected by surgery to be performed at the appropriate time.”
CAN THE OCCURRED PROBLEMS BE RETURNED?
Dr. Lecturer According to the information given by his member, Özcan, cataracts that develop in the eye do not cause any complaints in the initial periods, but in cases where low calcium continues, cataract now progresses and causes a decrease in vision level. Stating that this decrease in vision level negatively affected the life of the person over time, Dr. Lecturer Ü. Yasin Özcan said, “This situation can only be corrected by cataract surgery, in which we remove the cataract and replace it with artificial lenses. “There is no treatment for this visual impairment with drugs or drops other than surgery,” he said.
Stating that the optic nerve is permanently damaged as a result of the inflammation in the optic nerve as a result of the progression of Graves’ disease, Dr. Lecturer Özcan said that even if the thyroid gland is removed in these patients, there will be no return in the visual level of the patients, only more loss can be prevented from becoming blind.
Explaining that sudden vision loss is not an expected situation after thyroid surgery, Dr. Lecturer Member Yasin Özcan completed his words by saying, “I recommend our patients who notice sudden changes in their vision after such surgeries not to wait at all and consult an ophthalmologist as soon as possible”.