November 18

Thyroid Eye Disease 101 — TED/Graves’s Eye Disease

By fitness

November 18, 2022




Medically reviewed by Raymond Douglas, M.D., Ph.D., Cedars-Sinai

November 14-20, 2022 is Thyroid Eye Disease Awareness Week.

What is thyroid eye illness (TED)?

Thyroid eye illness, or TED, is an autoimmune dysfunction that causes irritation within the eye muscle mass, eyelids, tear glands and fatty tissues behind the attention. TED is usually referred to as Graves’ ophthalmopathy or Graves’ Eye Disease. This is as a result of TED most frequently happens as a part of Graves’ illness — an autoimmune situation that causes your immune system to assault the wholesome tissue of your thyroid, pores and skin and eyes.

If you could have Graves’ illness, you could have an elevated probability of creating thyroid eye illness. But TED is a uncommon illness and totally different from Graves’ illness and requires totally different remedy. Graves’ illness is the commonest reason for hyperthyroidism, the place your physique produces an excessive amount of thyroid hormone. TED also can happen with hypothyroidism, the place your physique produces too little thyroid hormone, however that is a lot much less frequent. When thyroid hormone ranges go up and down, it may possibly make your TED signs worse. Thyroid eye illness is extra frequent in girls, however is usually extra extreme in males.

Phases of thyroid eye illness (TED)

There are two phases of TED: lively (additionally referred to as acute) and inactive (additionally referred to as continual). TED begins with an lively section the place you immediately start to expertise signs. This section can final from about 6 months to 2 years. During the inactive section, many of the signs are inclined to get higher, however that is solely short-term. Scar tissue can kind within the eyelid and eye muscle in the course of the inactive section.

What could make thyroid eye illness (TED) worse?

Certain components can set off signs or trigger flare-ups.

  • Smoking
  • Fluctuating hormones, akin to in being pregnant
  • Stress
  • Eye trauma or surgical procedure
  • Other autoimmune circumstances akin to Type 1 diabetes, lupus or rheumatoid arthritis
  • Steroid use

What are the signs of thyroid eye illness (TED)?

TED is a severe illness that may worsen over time. Most individuals who have a thyroid situation akin to Graves’ illness begin noticing eye signs inside the first 6 months. These signs can embrace:

  • Dry, itching or gritty eyes
  • Eye tearing or redness
  • Pain behind the attention
  • Puffy pores and skin across the eyes or eyelid swelling
  • Double imaginative and prescient
  • Misaligned eyes or eyes that don’t work collectively
  • Bulging eyes (proptosis or exophthalmos)
  • Sensitivity to gentle

You may additionally have extra extreme signs akin to not with the ability to transfer your eyes or eyelids nicely, not with the ability to utterly shut your eyes or, in uncommon circumstances, lack of imaginative and prescient. This can have an effect on high quality of life as a result of it may possibly have an effect on your capacity to drive, learn and work and may influence your emotional well-being.

How does thyroid eye illness (TED) get identified?

Sometimes your HCP could make a prognosis of TED based mostly in your signs alone. To get a prognosis of thyroid eye illness, you have to a bodily examination, in addition to a watch examination. You may additionally have blood drawn to verify the standing of your thyroid, together with imaginative and prescient assessments and eyelid measurements.

It would possibly take visits to multiple HCP to get a TED prognosis. You could also be referred to see an ophthalmologist who's a physician that focuses on eye and imaginative and prescient considerations, particularly a thyroid eye illness specialist with superior coaching and expertise treating TED. A referral to an endocrinologist, who's a physician that treats hormone points, may additionally be advisable that can assist you handle your thyroid situation.

Sometimes the signs of TED akin to dry, pink and irritated eyes might be mistaken for allergic reactions. Tell your HCP about all of your signs and medical historical past, so there's not a delay in prognosis.

Managing thyroid eye illness (TED) signs

While TED isn’t thought-about to be curable, there are therapies that may assist handle your signs. The longer that TED stays untreated, the extra seemingly severe harm can happen. Treatment is usually began within the acute section, however can nonetheless assist in the course of the continual section.

At residence, you should utilize cool compresses or lubricating eye drops to provide your dry or irritated eyes some aid. Sunglasses might help shield your eyes from the solar and wind. To assist with the swelling and strain close to or in your eyes, strive sleeping along with your head elevated.

Certain medicines might help with eye swelling, akin to steroid medicines. There are additionally newer prescription infusions accessible that will assist relieve signs.

If your TED signs are extreme, your HCP would possibly suggest you could have surgical procedure. Orbital decompression might be carried out should you’re experiencing bulging eyes. This surgical procedure helps make the attention socket larger to lower the strain in your eyes. Eyelid surgical procedure may also be carried out in case your eyelids have pulled again an excessive amount of. This helps return them again to their regular place.

If you're involved that you just may need thyroid eye illness, speak along with your HCP. They can work with you to give you a remedy plan that may give you the results you want.

This useful resource was created with help from Horizon.

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