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Learning you have an autoimmune condition such asthyroid eye disease(TED) can be disconcerting. This condition commonly occurs in those with a hyperactive thyroid, but it can also affect those with a hypoactive thyroid and some with no prior thyroid issues. The hallmark of this eye disorder is the distinctive way the eyes may bulge.
When antibodies attack the eye muscles, thyroid eye disease may develop. The symptoms can include swelling of the surrounding fat and muscles, causing the eyes to protrude.
Jessica Olah / Verywell
Risk Factors
Thyroid eye disease affects about 1 million Americans. Women in particular are at risk, developing this condition at a rate of five to six times that of men. Anyone who is a cigarette smoker is at significantly increased risk of not only developing thyroid eye disease, but also contending with a more severe vision-threatening form.
Disease Progression
Those with thyroid eye disease can be in one of two phases. During the initial active phase of this condition, inflammation occurs, and efforts are concentrated on relieving eye symptoms.
Such symptoms can include:
This active phase of thyroid eye disease may typically last from six months up to two years. During this time, symptoms may continue to change. Treatments such as surgical options are put on hold until healthcare providers feel certain they can get solid results.
Meanwhile, the second period has been dubbed the stable phase. During this stable period, there is a relief of symptoms. The second stage is typically when patients undergo surgical cosmetic corrections of any eye protrusion or vision issues.
Treatment Options
Currently, there areseveral treatment optionsfor dealing with the symptoms associated with thyroid eye disease.
Dry Eyes
During the disease’s active phase, the eyelids may tighten and retract, making it difficult to blink properly. If the eyelid isn’t properly closed and the eye’s surface is left exposed, it can dry out and become irritated.
You can help alleviate this with frequent use of lubricating drops, gels, or ointments to help soothe any burning sensation. Instill drops frequently throughout the day. Save the thicker gels and ointments for the nighttime hours. These thicker products tend not to evaporate as quickly but may cause some blurring.
Double Vision
With thyroid eye disease, the muscles responsible for moving the eyes can become swollen and scarred, causing double vision. This may actually go away on its own. If not, there are several different options to try, including:
Eye Protrusion
When it doesn’t, one option is the use of the drugTepezza, which has been shown to help eye-bulging resolve in many cases. This medication helps to reduce swelling and inflammation.
There’s also the possibility of undergoing eye decompression surgery, in which some of the socket bone is removed to create more space for the swollen eye tissues. This can not only help you to feel better but also can assist in returning your appearance to what it was previously.
Eyelid Retraction
The retracted eyelids can also show more of the white of the eye and may make it appear as if someone is staring. Once the eyelid positioning has become stable, however,surgerycan be performed to reposition the eyelids more normally.
Vision Loss
In a small number of cases, thyroid eye disease may result in vision loss. Some signs that this may be occurring can be:
If you notice any signs of vision loss, it’s important to alert your healthcare provider immediately.Sometimes this can be due to eye surface dryness, which can occur if the lids don’t close properly. Dryness can be treated with drops, gels, or ointments.
It’s also possible for the ocular nerve to become compressed if the swollen eye begins to press on this. Use of medication such as anti-inflammatory drops, steroids, or even radiation can be given. Sometimes the healthcare provider may recommend surgery to help take the pressure off the nerve.
Prognosis
Determining how you will ultimately fare with thyroid eye disease depends on your individual case. Some people are fortunate to have mild symptoms, which resolve on their own with minimal treatment. In other cases, patients must contend with symptoms like double vision or retracted lids, which require some surgery.
Cosmetically, it’s more possible than ever to decrease eye bulging with the aid of medication or surgery. The result can be an appearance that you are more comfortable with and closely resembles the look you had previously.
Fortunately, only a small number of people, about 10% to 20%, deal with thyroid eye disease in its most severe form. Most never deal with related vision loss. Only occasionally is it necessary for patients to undergo surgery and other measures to preserve their vision.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ohio State University Casey Eye Institute,Thyroid eye disease center.University of Michigan,Thyroid eye disease (TED) or Graves eye disease.University of Michigan Kellogg Eye Center.Thyroid eye disease - what to expect.Brigham and Women’s Hospital,Thyroid eye disease.American Academy of Ophthalmology,New Drug Treats Thyroid Eye Disease Without Surgery.Cleveland Clinic.Thyroid eye disease.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ohio State University Casey Eye Institute,Thyroid eye disease center.University of Michigan,Thyroid eye disease (TED) or Graves eye disease.University of Michigan Kellogg Eye Center.Thyroid eye disease - what to expect.Brigham and Women’s Hospital,Thyroid eye disease.American Academy of Ophthalmology,New Drug Treats Thyroid Eye Disease Without Surgery.Cleveland Clinic.Thyroid eye disease.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ohio State University Casey Eye Institute,Thyroid eye disease center.University of Michigan,Thyroid eye disease (TED) or Graves eye disease.University of Michigan Kellogg Eye Center.Thyroid eye disease - what to expect.Brigham and Women’s Hospital,Thyroid eye disease.American Academy of Ophthalmology,New Drug Treats Thyroid Eye Disease Without Surgery.Cleveland Clinic.Thyroid eye disease.
Ohio State University Casey Eye Institute,Thyroid eye disease center.
University of Michigan,Thyroid eye disease (TED) or Graves eye disease.
University of Michigan Kellogg Eye Center.Thyroid eye disease - what to expect.
Brigham and Women’s Hospital,Thyroid eye disease.
American Academy of Ophthalmology,New Drug Treats Thyroid Eye Disease Without Surgery.
Cleveland Clinic.Thyroid eye disease.
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