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CONJUNCTIVITIS

Conjunctivitis is an inflammation of the inner lining of the eyelid.  This condition is common in persons with hyperthyroidism. 

As the following study shows, conjunctivitis "appears to be a prognostic marker for severe Graves ophthalmopathy" (TED).  If this is correct, not only should conjunctivitis be a serious concern to get corrected as soon as possible, but whatever nutrients help correct conjunctivitis may also be critical in correcting TED.

 

Ophthalmology 1995 Oct;102(10):1472-5

Superior limbic keratoconjunctivitis. A prognostic sign for severe Graves ophthalmopathy.

Kadrmas EF, Bartley GB

Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA.

PURPOSE: To study superior limbic keratoconjunctivitis in a relatively large group of patients and to determine whether a relation exists with thyroid dysfunction. METHODS: The medical records of 57 patients with superior limbic keratoconjunctivitis who were examined between 1980 and 1993 were reviewed. RESULTS: Thirty-seven patients (64.9%; 95% confidence interval, 51.1-77.1) had objective evidence of thyroid dysfunction. Of patients with superior limbic keratoconjunctivitis and thyroid disease, 33 (89.2%) had ophthalmopathy, which in 16 patients (48.5%) was sufficiently severe to require orbital decompression. CONCLUSION: Superior limbic keratoconjunctivitis is associated with thyroid dysfunction and appears to be a prognostic marker for severe Graves ophthalmopathy.

PMID: 9097794, UI: 97252254

The following study shows that histamine is high in the tears of persons with conjunctivitis.  This is probably the result of a deficiency of the enzyme histaminase, a copper enzyme which is essential for the breakdown of histamine.

 

Ophthalmology 1995 Dec;102(12):1958-63

Histaminase activity in patients with vernal keratoconjunctivitis.

Abelson MB, Leonardi AA, Smith LM, Fregona IA, George MA, Secchi AG

Harvard Medical School, Boston, MA, USA.

PURPOSE: To investigate the activity of histamine-degradating enzymes in tears and plasma of patients with vernal keratoconjunctivitis (VKC). METHOD: Tear and plasma samples were collected from patients with VKC and from age-matched control subjects. Histamine was measured by enzyme-linked immunosorbent assay in acid samples treated with perchloric to deactivate histaminase and in untreated samples. Tear cytology, skin test reactivity to histamine, and the sum clinical score of allergic signs and symptoms in patients with VKC also were evaluated. Nineteen patients with active VKC and six age-matched control subjects participated in this study. RESULTS: In untreated samples, tear histamine (mean +/- standard error of the mean) was 11.15 +/- 2.16 ng/ml in patients with VKC and 0.855 +/- 0.225 ng/ml in control tears (P < 0.001). In treated samples, mean tear histamine was 22.25 +/- 4.17 ng/ml in patients with VKC versus 10.64 +/- 2.85 ng/ml in control subjects (not statistically different). The ratio of histamine in treated to untreated samples (indicating histaminase activity) was significantly lower in patients with VKC (2.30 +/- 0.263) than in control subjects (17.57 +/- 5.97; P = 0.0001). Plasma histamine levels in untreated and treated samples were significantly higher in patients with VKC (untreated, 2.23 +/- 0.334 ng/ml; treated, 4.37 +/- 0.357 ng/ml) than in control subjects (untreated, 0.254 +/- 0.068, P = 0.0002; treated, 2.96 +/- 0.171 ng/ml, P = 0.0082). The enzymatic breakdown of histamine (treated/ untreated) in plasma was significantly decreased in patients with VKC (2.54 +/- 0.447) compared with control subjects (14.78 +/- 4.86; P = 0.0012). Skin reactivity to histamine was not increased in VKC. Tear histamine levels were significantly correlated to tear lymphocyte content in the general population and to tear basophils in the patients with tarsal-vernal VKC only. An increased number of tear eosinophils were correlated with elevated enzyme activity only in patients with tarsal-vernal VKC and to the clinical score only in limbal-vernal patients. CONCLUSION: The enzymatic degradation of histamine was significantly decreased in patients with VKC compared with control subjects in both tears and plasma, suggesting that this dysfunction may be a primary factor in the pathophysiology of VKC.

PMID: 9098303, UI: 97252845

Here is another study associating conjunctivitis (occurring in the spring, presumably from pollen allergies) with low histaminase levels. 

Int Arch Allergy Appl Immunol 1981;64(4):464-8

Studies on histamine and histaminase in spring catarrh (vernal conjunctivitis).

Mukhopadhyay K, Pradhan SC, Mathur JS, Gambhir SS

Patients with spring catarrh (vernal conjunctivitis) were studied for blood histamine (36) and plasma histaminase (16), and were compared with control histamine (22) and histaminase (19) levels. The patients group showed significantly higher histamine and lower histaminase levels than the respective controls. In addition, the patients also had higher eosinophil counts and erythrocyte sedimentation rate. The data suggest that a systemic allergic process may be the most important underlying causative factor in this disorder.

PMID: 6782024, UI: 81140929

The following quoted information from the Nutrition Almanac (4th Ed., pg. 83) on vitamin D indicates that this vitamin may be crucial in controlling conjunctivitis and therefore ophthalmopathy (TED).

Vitamin D and conjunctivitis.  Forty-one patients suffering from allergic conjunctivitis were given 50,000 units of vitamin D daily for 7 weeks.  Results: Twenty-nine patients experienced complete relief with vitamin D therapy, 11 showed marked improvement, and 1 remained unchanged. (Dr. Arthur A. Knapp, Columbia College of Physicians and Surgeons, as reported in Rodale, ed., Prevention, September 1969, pp. 80-82.)

Nutrition Almanac, pg. 196: "A deficiency of vitamin A, vitamin B-6, or riboflavin (B-2) may cause conjunctivitis symptoms.  The diet should be adequate in these nutrients to help prevent the condition. Certain forms of conjunctivitis are the result of a calcium deficiency."