Understanding Thyroid eye disease: Causes, Symptoms, and Management

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Thyroid eye disease

by Alike Medical Team ∙ Updated on June 13, 2023

Additional names

This group contains additional names: - TED

General

Thyroid eye disease is an eye disorder that causes inflammation and damage to the tissues around the eye, including muscles, fatty tissue and connective tissue. TED is an autoimmune condition, or one that happens because your protective immune system attacks your body. There are two phases of TED: the active or inflammatory phase and the stable phase. The active phase can last for months up to three years, while the stable phase follows when the inflammation stops. TED is often related to Graves disease, which is also an autoimmune disease. It can affect the thyroid, eyes and skin.

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Signs & symptoms

The signs and symptoms of thyroid eye disease include: * Dry eyes. * Irritated eyes due to a gritty feeling. * Watery eyes. * Red eyes. * Bulging eyes, also called proptosis. * A "stare". * Double vision, also called diplopia. * Difficulty closing your eyes completely. This can lead to an ulcer (sore) on your cornea. * Vision. * Pain behind your eyes and pain with eye movements. Symptoms normally affect both eyes, but sometimes you may only notice symptoms in one eye.

Diagnosis

A doctor will be able to diagnose thyroid eye disease by doing a physical eye exam. They will be able to examine both your eyelids and your eyes. If your doctor thinks that you have thyroid eye disease, they’ll order blood tests to check if your thyroid hormone levels and antibodies are too high or too low. Other tests your provider may request include: * Ultrasound of the eyes. * Computed tomography (CT). * Magnetic resonance imaging.

Treatment

The doctor will begin by treating you for thyroid disease if you have it. Treating thyroid diseases doesn’t treat thyroid eye disease, so your provider may suggest one or more of these therapies: * Over-the-counter medications- Eye drops to relieve dryness and irritation are generally non-prescription. You can buy them over the counter. You should use the drops that lubricate but avoid those that take away redness. * Prescription medications- The doctor may prescribe anti-inflammatory drugs like prednisone and other systemic steroids and/or rituximab. Discuss the side effects of these treatments with your provider. * Lifestyle changes and home remedies- The most important lifestyle change you can make is to quit smoking if you smoke. It raises your risk of developing TED by seven to eight times and makes TED’s active (inflammatory) disease phase longer. In addition, smoking decreases the effectiveness of treatment for thyroid eye disease. Other things you can do to be more comfortable include: -Using cool compresses on your eyes. -Wearing sunglasses. -Keeping your head higher than your body when you lie down. -Taking selenium supplements (after approval from your provider). Studies indicate that these may help people with mild active thyroid eye disease. -Taping your eyelids shut when you sleep. Being unable to close your eyes can lead to dryness and a corneal ulcer, which can cause scars on your eyes and loss of vision. -Wearing glasses with prisms to reduce double vision. -Using a patch on one eye to reduce double vision. -Keep your thyroid hormones level by following your health care provider’s suggestions and getting regular thyroid tests. * Surgery - Eyelid surgery: Tight eyelids keep your top eyelid from coming down and your bottom lid from coming up. This can lead to corneal damage. Eyelid surgery may make it easier to keep your cornea covered. - Eye muscle surgery: Your provider may recommend surgery to move your eye muscles and help to correct double vision. You may need more than one surgery. Orbital decompression surgery: This surgery relieves the pressure on the optic nerve by making the eye socket larger or taking away excess tissue. The surgery lessens the bulging of the eye. If you provider recommends other surgeries (eyelid, eye muscle), orbital decompression is usually done first. * Radiation to treat TED- The doctor may suggest radiation therapy to treat the inflammation of thyroid eye disease.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

National Institutes of Health ∙ World Health Organization ∙ MedlinePluse ∙ Centers for Disease Control and Prevention

☝ All information has been reviewed by certified physicians from Alike

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