Thyroid Eye Disease (TED) is an autoimmune condition that causes inflammation and damage to the tissues that surround the eye. These tissues include the muscles, as well as the fat and connective tissue.
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. The stable phase is what follows after the inflammation stops. TED is often related to Graves disease. Graves disease can cause both hyperthyroidism and hypothyroidism. Both can result in TED. TED is seen most commonly with hyperthyroid disease, and less commonly in hypothyroidism and in euthyroid (or normal thyroid levels).
WHAT IS THYROID EYE DISEASE (TED)?
Thyroid Eye Disease (TED) is an autoimmune condition that causes inflammation and damage to the tissues that surround the eye. These tissues include the muscles, as well as the fat and connective tissue.
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. The stable phase is what follows after the inflammation stops. TED is often related to Graves disease. Graves disease can cause both hyperthyroidism and hypothyroidism. Both can result in TED. TED is seen most commonly with hyperthyroid disease, and less commonly in hypothyroidism and in euthyroid (or normal thyroid levels).
WHOSE DOES TED AFFECT?
TED occurs more often in women than men. The median age is 43 years old.
People who may be more likely to develop TED are those who have family members with TED, and those who have low levels of the mineral selenium in your blood.
WHAT ARE THE SYMPTOMS OF TED?
- Dry eyes
- Eye irritation which causes a gritty feeling
- Watery eyes
- Red eyes
- Buldging eyes (also known as proptosis)
- Eyelid retraction, which causes a “stare”
- Difficulty closing eye completely, which leads to ocular exposure that can lead to problems with your cornea
- Double vision (also known as diplopia)
- Pain behind your eyes and pain with eye movements
- Eyelid swelling and redness
- Light sensitivity (also known as photophobia)
WHAT TESTS ARE DONE FOR TED?
TED is typically diagnosed by an eye exam. If TED is suspected blood tests to check your thyroid levels are usually preformed. Other tests may include and ultrasound of the eyes, CT or MRI scan of the orbits
WHAT IS THE TREATMENT OF TED?
Over-the-counter remedies:
- Artificial tears to lubricate the eyes and reduce redness, and selenium supplements if you have low blood levels.
Prescription medications:
- Prednisone or other systemic steroids, Rituximab, and Tepezza, an infusion specifically targeting TED.
Lifestyle adjustments and home remedies:
- Quit smoking to significantly reduce your risk and severity of TED.
- Use cool compresses on your eyes.
- Wear sunglasses and moisture chamber goggles at night if you have difficulty closing your eyes.
- Sleep with your head elevated.
- Take selenium supplements for mild active TED.
- Wear prism glasses or use an eye patch for constant double vision.
- Regularly monitor your thyroid hormone levels with a healthcare provider.
Surgical options:
- Orbital decompression surgery to alleviate bulging eyes and optic nerve pressure.
- Eye muscle surgery to correct double vision.
- Eyelid surgery to adjust the position or tension of the eyelids as needed due to TED's impact.
These treatments can be used individually or in combination depending on the severity and symptoms of your TED.
