What is thyroid eye disease?
Thyroid Eye Disease (TED) is a serious, vision-threatening condition that can get worse over time, if left untreated. The longer that TED goes untreated, the more likely it is for serious damage to happen to your eyes. The earlier you start treatment for your Thyroid Eye Disease, the better. Read on to learn about your TED treatment options.
How does ocular thyroid eye disease?
Thyroid eye disease may occur in patients who already know they have thyroid disease, or sometimes it’s the first problem that brings the person to the doctor’s office. The symptoms that occur in thyroid eye disease include dry eyes, watery eyes, red eyes, bulging eyes, a “stare,” double vision, difficulty closing the eyes, and problems with vision.
Research suggests that the cause of thyroid disease and thyroid eye disease is an autoimmune disorder. An imbalance or recognition problem occurs in the immune system. The immune system normally protects our bodies from foreign invaders such as bacteria or viruses, and also protects us from abnormal cells such as cancer. In thyroid eye disease, the immune system sets off an abnormal reaction to the muscles and fatty tissue around the eyes. Although many patients with thyroid eye disease will have abnormal blood tests for thyroid hormone levels, there are some people who get the eye symptoms even though the hormone levels are normal.
What are the symptoms of thyroid eye disease?
Thyroid eye disease can affect many different parts of the eye and surrounding tissues. Inflamed lacrimal glands may cause wet eyes or dry eyes, and these can both happen in the same patient at different times. Lubrication with eye drops or ointment can help to soothe this irritation. The abnormal immune reaction causes swelling in the tissues of the eyelids and orbit which can make the eyelids look puffy or as if the person has “baggy” eyelids. This can also create a sensation of pressure around the eyes. The swelling can be surgically altered to bring the lids back to a more normal shape.
The muscles in the eyelids tighten and pull the upper lid up and the lower lid down. This creates a startled look with too much of the whites of the eyes showing. This also can be surgically improved. The muscles which control movement of the eyes may be increased in size by the swelling. This can create problems with double vision and focusing. Prism glasses may be helpful, and this can also be improved by surgically moving the eye muscles.
These symptoms of redness, irritation, pressure and double vision are treated with lubrication, anti-inflammatory medications and prisms for the double vision, and will require some time to stabilize before your doctor will recommend surgical intervention. Typically, the active or inflammatory stage of thyroid eye disease lasts one to three years. During this time, your doctor will avoid surgically treating these symptoms because the tissues are constantly changing, and the results will not be stable. However, there are some problems that are dangerous to your vision, and these require more immediate treatment.
What are the treatments for thyroid eye disease?
Early Thyroid Eye Disease treatment can help prevent serious eye damage.
Common Thyroid Eye Disease treatments are:
- Eye drops or gel
Over-the-counter eye drops may help provide relief for dry, gritty eyes. In some cases, doctors will prescribe a specific type of eye drops to use.
For retracted eyelids, or eyelids that can’t close, a lubricating gel can be used to prevent the eye from getting dry while you sleep.
- steroid pill
Steroids are one of the most common treatments and can potentially provide some symptom relief. People with TED usually start on a higher dose which is slowly lowered. This is done to help avoid the long-term negative effects of steroid usage, such as weight gain and increased risk of infections. Orbital radiotherapy icon Orbital radiotherapy icon
- Radiotherapy
Orbital radiotherapy (ORT) is another approach used to treat TED. This treatment aims beams of energy (radiation) at a precise point on the body. In the case of TED, the area targeted is behind the eye. ORT may provide some symptom relief for some people with TED.
- Thyroid Eye Disease surgery
When TED reaches the “chronic” phase, surgery is sometimes used to correct damage that resulted from scarring. It usually takes multiple surgeries to correct the issues caused by TED. These surgeries are often done in a specific order.
References
https://www.thyroideyes.com/thyroid-eye-disease-treatment/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752271/
https://my.clevelandclinic.org/health/diseases/17558-thyroid-eye-disease
