What is thyroid eye disease?
Thyroid eye disease (TED) is an eye disorder that causes inflammation and damage in the tissues around the eye, including muscles, fatty tissue, and connective tissue. TED is an autoimmune condition, or it occurs because your protective immune system attacks your own body.
There are two stages of thyroid eye disease: the active or inflammatory stage and the stable stage. The active phase can last from months to three years, while the stable phase is when the inflammation stops.
Thyroid eye disease is often associated with Graves’ disease, which is also an autoimmune disease. It can affect the thyroid, eyes and skin.
Graves’ disease can cause hyperthyroidism, which means your body releases too much thyroid hormone. Less commonly, Graves’ disease can also cause hypothyroidism, which means your body doesn’t release enough hormones. Both can result in thyroid eye disease, but people with low levels of thyroid hormone who have swollen eyes and loss of eyebrow hair have severe cases of hypothyroidism.
However, thyroid eye disease can occur in people with normal levels of thyroid hormones. Thyroid conditions can also cause secondary glaucoma due to damage to the optic nerve.
Who does thyroid eye disease affect?
Thyroid eye disease occurs more in women than in men. The average age for diagnosis of TED is 43 years. However, you may be diagnosed much earlier or much later than 43.
You may be more likely to develop thyroid eye disease if you:
1. Other family members have thyroid eye disease.
2. You have low levels of the mineral selenium in your blood.
3. One treatment for hyperthyroidism or Graves’ disease is radioactive iodine. This treatment may make active thyroid eye disease worse unless your provider also gives you steroids along with iodine.
What are the signs and symptoms of thyroid eye disease?
Signs and symptoms of thyroid eye disease include the following: –
1. Dry eyes.
2. Irritated eyes due to gritty feeling.
3. Moist eyes.
4. Red eyes.
5. Bulging eyes, also known as proptosis.
6. Staring.
7. Double vision, also known as diplopia.
8. Difficulty closing your eyes completely. This may cause ulcers (pain) on your cornea.
9. Sight.
10. Pain behind your eyes and pain with eye movement.
11. Symptoms usually affect both eyes, but sometimes you may notice symptoms in only one eye.
Is Thyroid Eye Disease Contagious?
No. Thyroid eye disease is not contagious. You can’t catch it from anyone, and you can’t transmit it to anyone.
What tests will be done to diagnose thyroid eye disease?
A healthcare provider will be able to diagnose thyroid eye disease by performing a physical eye examination. They will be able to examine both your eyelids and eyes.
If your healthcare provider thinks you have thyroid eye disease, they will order blood tests to check if your thyroid hormone levels and antibodies are too high or too low.
Other tests your doctor may request include:
1. Ultrasound of the eyes.
2. CT scan.
3. MRI.
How is thyroid eye disease treated? How is thyroid eye disease treated?
If you have thyroid disease, your doctor will start your treatment. Treating thyroid disease does not cure thyroid eye disease, so your provider may suggest one or more of the following treatments:
Over-the-counter medications to treat TED
Eye drops to relieve dryness and irritation are usually non-prescription. You can buy them over the counter. You should use drops that lubricate but avoid drops that remove redness.
Your doctor may also suggest selenium supplements if you have low levels of this mineral in your blood.
Some studies have shown that drinking aloe vera juice reduces inflammation levels in some cases.
Prescription medications to treat TED
Your doctor may prescribe anti-inflammatory medications such as prednisone and other systemic steroids and/or rituximab. Discuss the side effects of these treatments with your doctor.
There is also a new drug available only for thyroid eye disease called teprotumumab.
Lifestyle changes and home remedies to treat TED
The most important lifestyle change to make if you smoke is to quit smoking. This increases your risk of developing TED by seven to eight times and prolongs the active (inflammatory) disease phase of TED. In addition, smoking reduces the effectiveness of treatment for thyroid eye disease. Other things you can do to be more comfortable include:
1. Use a cold compress on your eyes.
2. Wear sunglasses.
3. While lying down, keep your head higher than your body.
4. Taking selenium supplements (after approval from your doctor). Studies indicate that these may help people with mildly active thyroid eye disease.
5. Closing your eyelids with tape while sleeping. Being unable to close your eyes can lead to dryness and corneal ulcers, which can lead to scarring of your eyes and loss of vision.
6. Wearing glasses with prism to reduce double vision.
7. Using a patch on one eye to reduce double vision.
8. Maintain your thyroid hormone levels by following your health care provider’s suggestions and getting regular thyroid tests.
Surgery to treat thyroid eye disease
1. Eyelid surgery:- Tight eyelids prevent your upper eyelid from coming down and the lower eyelid from coming up. This may cause damage to the cornea. Eyelid surgery can make it easier to keep your cornea covered.
2. Eye muscle surgery:- Your doctor may recommend surgery to help move your eye muscles and correct double vision. You may need more than one surgery.
3. Orbital decompression surgery:- This surgery relieves pressure on the optic nerve by enlarging the eye socket or removing excess tissue. Surgery reduces eye bulge. If your doctor recommends other surgery (eyelid, eye muscle), orbital decompression is usually done first.
Radiation to treat thyroid eye disease
Your doctor may suggest radiation therapy to treat inflammation of thyroid eye disease.
How can I prevent thyroid eye disease?
You can’t prevent thyroid eye disease.
Note, do not take any medicine without doctor’s advice. Self-medication is life-threatening and can lead to serious medical conditions.