# new to this



## newpatient (Feb 3, 2018)

I went to my optician for my usual yearly eye exam. I was told I have very dry eyes and one of the layers of the eye that produce tears have lost (i was told there are three layers). I was then told by my optician "I think you have Graves Disease". She prescribed some eye drops and asked me to return in 6 weeks to check the eyes. I said so what do i need to do about possible Graves Disease and she did not really reply. I therefore went to my doctor and told her and my doctor said I cannot have Graves because I have an underactive thyroid and graves is usually associated with people who have an overactive thyroid. She said I also do not have protruding eyes. She said she would send me for blood tests. I get blood tests done anyway as I am on Thyroxine but she also wanted me to have a test for autoimmune deficiency which she said goes with graves. Blood tests came back clear. Thyroid is stable and I do not have auto immune deficiency so she said show copies of the results to your optician and put this idea right out of your mind. I showed the results to my optician who said ok glad you do not have autoimmune deficiency and glad your thyroid is stable. I then said so what does that mean in relation to graves disease because my doctor said i cannot have it because i dont have protruding eyes or an overactive thyroid and furthermore these tests are clear.. My optician said the doctor was wrong and you most certainly can have graves disease with an underactive thyroid and you only get popping eyes when the graves disease has progressed not when it is at the very early stages. And the optician also said because I have extremely dry eyes, dry eyes go hand in hand with graves disease. So I then asked her to commit one way or the other whether I do or do not have Graves and she did not give me a clear answer. She did not say yes you have it or no you do not.

I am seeking a second opinion from another optician who is willing to see me. All I want is a simple yes or no answer which for some reason my optician is unwilling to give me. She is apparently well known in my area for being very thorough and intelligent and has previously worked at the eye department of my local hospital.

I do not understand why she is reluctant to commit herself. She is very good at other matters ie dry eyes and blepharitis but her non commitment for Graves has left me bewildered and worried because if Graves is not treated it can lead to other things.


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## Lovlkn (Dec 20, 2009)

Welcome to the board!

Best thing you can do - get copies of your thyroid tests and post results and (ranges) and we can help you interpret.

First off - an optician isn't the right doctor to be diagnosing a thyroid eye disease in a patient. There are eye specialists who have experience in thyroid eye disease diagnosis.

Your current eye doctor is doing you an injustice by sharing their opinion and insisting on a disease they have no medical ability to order tests for. All they can provide is a referral to an eye specialist. Did they have any suggestions on how to treat?

The best eye drop I have found is called Retaine. You will have to look for it as not many retail stores stock it although I have found at both Walgreens and CVS. It is a blend of oils and if you research dry eye you will realize the oils on your eyelash line are an important part of moisturizing your eyes. Saline drops are only 1 part of the moisture eye and most people moisturize with a saline type of drop. You might also consider an eyelid wash and warm pack on your eyes several times daily to moisturize without prescription med's to see if it helps.


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## newpatient (Feb 3, 2018)

Lovlkn said:


> Welcome to the board!
> 
> Best thing you can do - get copies of your thyroid tests and post results and (ranges) and we can help you interpret.
> 
> ...


I left the copies of my results with the optician. I have an appointment with two other opticians and they will check my eyes and tell me what they think. I use Hydrosan extra eye drops which i have been told is the best for my eyes. I appreciate what you are saying about eye drops but my optician said before you can know what eye drops are the best you have to look into the eyes and see the state of the eyes and then know what will be the best as not all dry eye drops suit all kinds of dry eye conditions. I will only use what I have been told to use from the lady looking into the back of my eyes. My optician may be well known as highly intelligent etc and may have a good reputation in my area but she is not telling me anything about Graves. I asked her if I need to go to the hospital to get them looked at by a consultant and she sad no. When I get my second opinion then I will decide what to do next

She also started talking to me about Hashimotos disease which I know of only because a lady I work with has it. She said to me "oh another eye disease is hashimotos but you do not have that because you are not overweight and have not got thinning hair. Sorry but why talk to me about something that is not relevant and waste my time like that. I need to know if I have got Graves. Good grief

Next thing she will be talking to me about is detached retinas lol


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## Lovlkn (Dec 20, 2009)

Why are you going to opticians?

If you are concerned - you should make an appointment with a thyroid eye specialist.

Why not post some of your thyroid hormone lab results?


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## newpatient (Feb 3, 2018)

Lovlkn said:


> Why are you going to opticians?
> 
> If you are concerned - you should make an appointment with a thyroid eye specialist.
> 
> Why not post some of your thyroid hormone lab results?


I do not want to post my results. I do not see the point. My optician has them and said they were good


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## jenny v (May 6, 2012)

We really can't help much more unless you're willing to post your results. Without knowing what they have tested and what the results are, there's no way to tell if they are "good".


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## Lovlkn (Dec 20, 2009)

Ophthalmologist - This is the type of eye doctor who can assist you in your eye issues. They are a Medical Doctor. An Optician is not qualified.



> Ophthalmologists differ from optometrists and opticians in their levels of training and in what they can diagnose and treat. As a medical doctor who has completed college and at least eight years of additional medical training, an ophthalmologist is licensed to practice medicine and surgery. An ophthalmologist diagnoses and treats all eye diseases, performs eye surgery and prescribes and fits eyeglasses and contact lenses to correct vision problems. Many ophthalmologists are also involved in scientific research on the causes and cures for eye diseases and vision disorders





> Optometrists are healthcare professionals who provide primary vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes. An optometrist is not a medical doctor. An optometrist receives a doctor of optometry (OD) degree after completing four years of optometry school, preceded by three years or more years of college. They are licensed to practice optometry, which primarily involves performing eye exams and vision tests, prescribing and dispensing corrective lenses, detecting certain eye abnormalities, and prescribing medications for certain eye diseases





> Opticians are technicians trained to design, verify and fit eyeglass lenses and frames, contact lenses, and other devices to correct eyesight. They use prescriptions supplied by ophthalmologists or optometrists, but do not test vision or write prescriptions for visual correction. *Opticians are not permitted to diagnose or treat eye diseases.*


https://aapos.org/terms/conditions/132


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## newpatient (Feb 3, 2018)

Lovlkn said:


> Ophthalmologist - This is the type of eye doctor who can assist you in your eye issues. They are a Medical Doctor. An Optomitrist is not qualified.
> 
> https://aapos.org/terms/conditions/132


I understand what you are saying. I googled my opticians and got this...

*( Name edited out) Optometrists,, has built a strong reputation for providing the highest standard of optical care. Local GP's regularly refer their patients to our highly qualified optometrists.*

*We are able to offer the best possible choice when it comes to frames, lenses and testing technology. From designer glasses, such as Tiffany and Ralph Lauren, to digital photography and dyslexia assessments, we are guaranteed to have what you need.*

*Our professional optometrists and dispensing opticians take time with each and everyone to ensure our impeccable customer service is maintained.*

I got the results of the blood tests and my doctor explained what they meant and so if she is satisfied that they are good results and that I have no need to worry then that was good enough for me. I then took them to the eye test and the lady said they were good. So i two medical professionals both say the results are good then they must be. At the appointment she started saying to me "oh there is another eye disease called Hashimoto's but you do not have that because you are not overweight and do not have thinning hair. I went on to tell her that I know about Hashimoto's because a lady I work with has that and the lady I work with is very overweight and has thinning hair. Then I thought to myself why are you wasting my time talking about an eye disease I do not have and not likey to have because what you should be doing is talking to me about Graves disease which for some reason you are reluctant to delve into further. This is why I am going somewhere else for a second opinion. The lady is being very thorough in trying to sort out my dry eyes and blepharitis and wants to see me every few months to check them and see if the medication for both are working but I am stunned as to why she is ignoring the Graves. I am 54 and she is a lot older than me (maybe mid to late 60s) and she said you are still young and I want to do all I can to help you maintain the best possible eyes I can. I do get that and I do realise that some people have far worse eyes than me but the only thing I am not happy about is the Graves. I am wondering whether she may think she has misdiagnosed me and is too embarassed to say sorry I made a mistake you do not have Graves Disease and then her perfect reputation would be at stake. Anyway all I can do is see these two other people in two weeks time and take it from there. I will tell them everything and see what they say


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## Scanders (Sep 9, 2015)

It is possible to have Graves Ophthalmopathy (thyroid eye disease, or TED ) without having an overactive thyroid. Not typical, but it happens. I putzed around with an optometrist when I had some weird eye symtpoms, who sent me to a retinal specialist, and they both missed the TED in spite of obvious symptoms, although I didn't have the Graves diagnosis at the time, (but plenty of symtpoms--I just thought it was something else.)

But you said your autoimmune status was checked by your doctor, so your auto-antibody level should be able to give some credence to whether or not its TED. And, I'm not a doctor, but lots of things can cause dry eyes and blepharitis, if that's what she based her original statement on. Most importantly, you are being proactive and having your dry eyes addressed and treated, with ongoing monitoring. Hope that helps.


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## newpatient (Feb 3, 2018)

Scanders said:


> It is possible to have Graves Ophthalmopathy (thyroid eye disease, or TED ) without having an overactive thyroid. Not typical, but it happens. I putzed around with an optometrist when I had some weird eye symtpoms, who sent me to a retinal specialist, and they both missed the TED in spite of obvious symptoms, although I didn't have the Graves diagnosis at the time, (but plenty of symtpoms--I just thought it was something else.)
> 
> But you said your autoimmune status was checked by your doctor, so your auto-antibody level should be able to give some credence to whether or not its TED. And, I'm not a doctor, but lots of things can cause dry eyes and blepharitis, if that's what she based her original statement on. Most importantly, you are being proactive and having your dry eyes addressed and treated, with ongoing monitoring. Hope that helps.


Yes thanks. I am going to go back to my doctor to get new copies of my blood test results to give the new opticians so they can check my symptoms against the results. My own optician seems to think my dry eyes are caused by air conditioning and she said that with air conditioning, the filters need to cleaned regularly and in most cases they are not.

so until I go for the second opinion and see what they have to say, I am not going to worry about this. I am going round in circles trying to work this out and I am not medically trained and it is only going to stress me out. I do not have any eye pain or discomfort and my general sight is reasonable so I will just forget about it until the 17th February when I see the other two people about it. I will update you then

edit... the other thing that is putting me off this optician is I take eye vitamins. She said take one per day and then when I saw her again she said why are you taking only one per day and said because you advised me to and then she said most people take two so take two

I give up


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## Lovlkn (Dec 20, 2009)

You might also look into Sjogren's which can cause dry eyes

https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/diagnosis-treatment/drc-20353221


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## newpatient (Feb 3, 2018)

Lovlkn said:


> You might also look into Sjogren's which can cause dry eyes
> 
> https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/diagnosis-treatment/drc-20353221


I had my eye exam with the second optomertrist and if I am perfectly honest I did not feel confident that she accurately answered my fears and questions and did not even want to look at the copy of my thyoid and auto immune blood test results although she took a copy of the to keep at the end of the appointment. Her conclusion was that in her view I do not have graves because I could move my pupils around without discomfort and I do not have double vision. but this morning I have woken up with painful eyes so I am confused as to what could cause this pain upon waking up. Could it be tiredness or eye strain or the blepheritis. At my appointment I mentioned that I have been told to take antibiotics for blepheritis and she did not say whether she agreed with this or not but she told me to buy blepheritis wipes to wipe over the eyes.

I felt that this second opinion appointment was a bit of a waste of time as I explained the severity of my dry eyes an she made absolutely no comment. I think a trip to the local eye hospital where I would be seen by a consultant would have been better


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## Lovlkn (Dec 20, 2009)

> I left the copies of my results with the optician.


Please post your thyroid lab results.


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## newpatient (Feb 3, 2018)

Lovlkn said:


> Please post your thyroid lab results.


Thyroid Peroxidase normal

Thyroid antibodies 44

Thyroid functon test

Serum free T4 level 21.4

Serum TSH level 0.32


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## joplin1975 (Jul 21, 2011)

Could you edit your post and include the reference ranges, please?


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## newpatient (Feb 3, 2018)

You are not a medic. I have seen another optometrist. I do nit have the results with me and do not really want to post them on here. My first optometrist looked at the results and she seemed pleased .


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## joplin1975 (Jul 21, 2011)

Ok?

I am not a medic but I am a thyroid patient and have years of experience reading results. However, in order to do so, I need the reference ranges.

If you don't want help or you don't want me or anyone else to see your results, that is perfectly fine. But then I don't see the point in posting on a thyroid board.


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## jenny v (May 6, 2012)

I am going to lock this thread. We have reached an impasse and without further info on your labs, there is not much we can do to help. We have given you suggestions and advice, which you have argued with or rejected, so there's not much more we can do.


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