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Press release date September 18 2006

Smoking and thyroid eye disease linked
Further evidence of the additional risks of eye disease caused by tobacco use is highlighted by the publication of a systematic review of international studies on thyroid eye disease (also called Graves’ ophthalmopathy) by the journal ‘Eye’. The review published this week looked at 15 clinical studies into eye complications of Graves’ Disease, an autoimmune disorder causing over-production of thyroid hormones particularly in women aged 30 to 50. Thyroid eye disease is a common and disabling complication of Graves’ disease, the commonest type of overactive thyroid disease in the UK. The condition is named after the Dublin physician Dr Robert Graves who described it over 160 years ago. The review concludes: ‘There is strong evidence for a causal association between smoking and the development of thyroid eye disease (TED) among patients with Graves’ disease. Current smokers are also more likely to experience more severe symptoms or poorer outcome of treatment of TED’. The authors recommend that patients with Graves’ disease should be educated about the extra risk that smoking poses to their eyes and offered help to stop smoking. Eye problems, including prominent eyes and puffy eyelids, are a very common symptom of the thyroid condition Graves’ Disease (hyperthyroidism). It is estimated that 400,000 people in the UK have thyroid eye disease. Up to one in 20 people in the UK have thyroid problems at some time in their lives and some specialists believe that they are becoming more common. Graves’ Disease is responsible for 80% of hyperthyroidism cases – where too much thyroid hormone is present. Most patients with Graves’ Disease have some changes in their eyes on detailed examination. About 45% will have visible changes (puffiness, staring eyes) and in about 5% of patients severe problems develop: the eye may protrudes so much there is a risk of deteriorating vision, double vision and the eyelids not closing or blinking correctly leading to ulcers on the cornea. Review co-author Mr Simon Kelly, Consultant Ophthalmologist in Bolton and a member of the Royal College of Ophthalmologists’ Ocular Public Health Group, says “this study will add to pressure on EU legislators to include the message ‘Smoking causes blindness’ on cigarette packaging. This research adds further evidence of the harmful effect of smoking on the eyes in support of that call”

“Awareness of the ocular hazards of smoking is low. The Royal College of Ophthalmologists have called for the message ‘Smoking causes blindness’ to appear on tobacco products. Rules concerning warnings on cigarette packaging are decided at European level – although we now understand that this may not preclude action by individual member states. Our call was highlighted along with our partners the Royal National Institute of the Blind (RNIB) and the AMD Alliance at European level in May in a seminar hosted by MEP Ms Liz Lynne at the European Parliament.” The lead author of the review is Dr Judith Thornton from the University of Manchester. ends For more information, please contact Amanda Hayhurst, 0772 0205581, or Richard Hayhurst, 07711 821527. Editor’s Notes 1) This publication is part of an ongoing review of the link between smoking and eye disease by the Eyes and Tobacco Study Group involving researchers and clinicians in Bolton and Manchester. The review article in Eye is available at 2) Information about the presentation by the College and partners at the European Parliament is on the College website at The joint position paper for the European campaign is at 3) An answer from the EU Commission in response to a question on this issue -posed by the leader of the Labour Group in the European Parliament, Mr Gary Titley MEPappeared this week at 4) The work of the Royal College of Ophthalmologists’ Ocular Public Health Group is ends


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