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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7373
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have been seeing my eye doctor regularly for repeated bouts

Resolved Question:

I have been seeing my eye doctor regularly for repeated bouts of episcleritis. My left eyeball "feels" larger to me than my right one and when the eye doctor measured it for me it measured 1mm larger than my right one.... This measurement has remained steady for 1 year and has not changed... My eye doctor says that a 1mm variation is not unusual and since it is remaining constant that we should just keep an eye (no pun intended) on it..... My left eye does tear a bit and is slightly tender if i press it but no pain. I do have hashimoto's thyroiditis but have been told that it is rare for this to affect your eyes.... I wan't to get your opininon.....
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I can help you tonight.

Customer :

it says u sent me an answer but it's not here

Dr. Rick :

That is because we're just getting started.....

Customer :

oh

Customer :

sorry

Dr. Rick :

Your ophthalmologist is correct 1mm difference between the eyes, either on the length of the globes or the amount of protrusion from the edges of the orbital rim (often tested in cases of thyroid eye disease) is perfectly normal.

Dr. Rick :

No problem :o)

Customer :

ok. is it normal for me to "feel" the difference? also since I have hashimoto's should I be concerned or seek further testing.... also episcleritis has been several times

Dr. Rick :

Was a systemic disease process ever uncovered that may be associated with your recurrent bouts of episcleritis?

Customer :

not sure what u mean specifically but i know that i have fibromyalgia, cfs, hashimoto's

Dr. Rick :

No. As you might already know, the level of thyroid function/dysfunction is not related to the amount or severity of thyroid eye problems.

Dr. Rick :

Ok, there is a work up that is sometimes done after a person has a few bouts of episcleritis/scleritis ....nothing to worry about

Customer :

so, no connection between hashimoto's and the eye? also, this past year I was suffering from CMV (cytomegalovirus)

Customer :

which is

Customer :

?

Customer :

oh, also I do have rosacea which my eye dr and my dermatologist said can also affect the eye so I was on 2 or 3 rounds of minocycline (minocin)

Dr. Rick :

Yes and no on the eye association between Hashimoto's and the eye. The eye problems come about due to antibodies that are cross sensitive to the thyroid tissue and the muscle/orbit tissue of the eyes...that is what can lead to the protrusion of the eyeball in thyroid eye disease. The eye problems do not happen in every case of Hashimoto's....so you don't have to worry, esp, since it sounds like you are in good hands.

Dr. Rick :

I'm playing catch up with your posts :)

Customer :

ok, no prob

Customer :

just obsessed with this as I don't wan't to end up with a protruding eyeball

Dr. Rick :

No need to worry about the workup for episcleritis/scleritis....I was just wondering. Minocin is good for the rosacea.

Dr. Rick :

I don't blame you....but there are a lot of things that can be done if your eyes start to show signs of being involved....and like I said it is only in a small percentage of thyroiditis cases......

Customer :

ok so, what about that I can actually feel the 1mm difference and the tearing / sensitivity to touch? also, it seems odd but one day I feel the difference more and then at times it seems like it goes down - can allergies also add to this?

Customer :

what could be done?

Dr. Rick :

Yes, allergies can add to your discomfort. As to you actually being able to feel a 1 mm difference, I think that you are just worried more then actually "feeling" it. If anything was to start to happen from the thyroid condition to the eye it would be a painless process.....

Customer :

since Fibro / cfs are autoimmune and inflamitory probs can this affect the eyes

Customer :

the reason i believe i "feel' it is because that is what originally brought me to see my eye dr. because of the strange sensation of feeling larger.

Customer :

what could be done if g-d forbid the eye probs were to progress? is there anything I should be doing to check on it? should I worry about "Graves" because of the hashimoto's

Dr. Rick :

Well, first treat with steroids, then stronger medicine to decrease immune function, then orbital surgery, eyelid surgery.....lots of things. But, you've not even started to show any problems yet, so keep the faith, keep seeing your ophthalmologist, keep being aware of your health, get all the information you can (by talking to the very nice doctors on justanswer ;o) ) and things should be fine.

Customer :

<LOL>

Dr. Rick :

Yes, Graves disease is the name given when someone starts to have eye/orbital problems from thyroid disease....but don't worry. Do be informed. Do be active in your care. Do make sure you are comfortable with the doctors treating you. Do find other doctors if your not. And things will be the best that they can be.

Dr. Rick :

Also have a great holiday season.

Customer :

my immune system is all out of whack from the Fibro / CFS / Rosacea / Hashimoto's / Episcleritis and the CMV..... Could the CMV have affected it? Since all these things are autoimmune it seems like my body it attacking itself..... Y?

Customer :

u 2

Customer :

Also, are there any bloods that i should have done that would be related to anything affecting the eyes

Dr. Rick :

Yes. your immune system is not being very nice, and yes CMV can stir things up. But all you can do is balance immunosupression (steroids,meds etc) with side effects and hope for the best

Customer :

can the cmv cause permanent damage to the eyes?

Dr. Rick :

The list of lab tests is huge and would be tailored to your specific symptoms and complaints at the time....It really sounds like you have some good doctors on your side and, I would bet, you've had more then your fair share of lab work.....

Customer :

oh, sould the sensitivity to touch be a concern with regard to my left eye and also the tearing

Customer :

oops <should>

Dr. Rick :

Now you are getting into another whole ball of wax. My primary job is retina diseases so I do see CMV doing nasty things to eyes, but I don't get the impression that you have to worry about any of those.

Customer :

also, sounds crazy but ccan a herniated disc in the neck affect the eyes?

Dr. Rick :

not in my experience

Dr. Rick :

good thing I'm getting to be a faster typist since I started on this site...Whew!

Customer :

ok - the CMV lasted in my system for around a year and the bloods only now show the numbers to have decreased.... is there anything I should ask my regular doctor or eye doctor to check with regard to the cmv

Customer :

LOL

Customer :

and the sensitivity to touch?

Dr. Rick :

no. CMV issues in the eyes are not subtle....don't worry about them missing it.

Customer :

sorry I send so many questions at once (i type fast)

Dr. Rick :

that is ok

Customer :

BTW - is your practice here in NY?

Dr. Rick :

No. But I trained in NYC. I am currently living in Northern Wisconsin

Dr. Rick :

I used to live in Westchester county, and the Villiage

Customer :

about the sensitivity to touch and the tearing???

Dr. Rick :

Don't touch your eye and it won't hurt :)

Customer :

Oy Vey - Wisconsin..... <LOL>

Customer :

wise guy......... <LOL> so, not to worry about that?????

Dr. Rick :

The tearing could be some mild blepharitis....could use natural tears. Also the bouts of episcleritis could leave things a little tender and teary....

Dr. Rick :

truth

Customer :

ok...........

Customer :

100% Truth???

Dr. Rick :

Just like my Grandma says : Oh Veys Meir

Customer :

A member of the tribe hmmmmm

Dr. Rick :

yup.

Customer :

Ok, so - in your opinion and 100% truth, I shouldn't worry?

Dr. Rick :

yes. Continue to gather all the info you can on whats going on, but in this case, don't worry.

Customer :

Just like a jewish girl to be paraniod about aesthetics and of course my sight......

Dr. Rick :

That is soooo true. You must know my sister!

Customer :

Many thanks, XXXXX XXXXX and Happy Everything.....

Customer :

We all know each other especially in NY......

Dr. Rick :

you too. Take care and let me know if I can help you again some day. Best of luck to you. It has been a pleasure chatting with you.

Customer :

And with you.... Thanks for the reassurance.....

Dr. Rick :

That's why they pay me the Big Bucks, I guess.....

Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
k
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7373
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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