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Hypothyroidism. Developed shrinking of eye and squint in eye. What is the disease called?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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My mother-in-law is 55 yr old. She has hypothyroidism TSH 8.65 (Normal 0.4-4.2), fasting blood sugar at 123 (normal 60-100), total cholesterol at 257 (normal <200).

For the last few months, her left eye shrinks almost 70-80% when she thinks a lot, which she does quite often. Recent development/deterioration is her left eye shrinks more often than earlier. Beyond this, she has developed squint on the left eye. Left eye pupil (eyeball) moves extremely outwards, when right eye is looking straight. Her left eye is watery. What is the issue? What will happen to her left eye vision.
Posted Wed, 27 Feb 2013 in Vision and Eye Disorders
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Hi,

Thank you for posting your query.

The eye symptoms reported by you in your mother-in-law are probably related to the nerve supply of muscles of eyeball.

There are three cranial nerves (originating from the brain), which are responsible for moving the eyeballs in different directions, and also for lifting the eyelid, and maintaining the size of eyes. They start from a part of brain called as brainstem.

The most common reason for involvement of these nerves could be lack of blood flow to brain. In some cases, it could be due to infection also. Both diabetes and high cholesterol in your mother in law can be risk factors for lack of blood flow to brain (blood clots).

There is no risk of losing eyesight or vision, as there is a separate nerve for that.

You should show her to a neurologist for evaluation and treatment.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) CMC Vellore XXXXXXX Consultant Neurologist,
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by
 
Follow-up: Hypothyroidism. Developed shrinking of eye and squint in eye. What is the disease called? 12 minutes later
1) Will there be chances of glaucoma?
2) Will her problem increase further? What will happen if left untreated?
3) What is the treatment for this?
 
 
Answered by Dr. Sudhir Kumar 8 minutes later
Thank you for getting back with more questions.

My replies to your queries are below:

1. These symptoms are not suggestive of glaucoma. Reduced eye sight and headaches could be the symptoms of glaucoma. In any case, glaucoma can be excluded by a routine eye check, by measuring eye pressure (which is elevated in cases of glaucoma).

2. Problems may persist or increase, if left untreated.

3. Usual medications for this problem could be blood thinners such as aspirin.

Another cause to be excluded is myasthenia (weakness of muscles), which also can be treated with simple medications.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Hypothyroidism. Developed shrinking of eye and squint in eye. What is the disease called? 24 hours later
If it is involving blood clot in brain, how severe it is?

Why is this squint happening? FYI - even her left looks watery..

Her father had glaucoma, it seems.
 
 
Answered by Dr. Sudhir Kumar 3 minutes later
Thank you for getting back.

If the blood clot is there in brain, it is very small and would get better with medications.

Regarding galucoma evaluation, it takes 5-10 minutes to check the eye pressure and visual fileds. So, I suggest that you get an eye check up done to exclude glaucoma.

Treatment of glaucoma too is very easy, if diagnosed early.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
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