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

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


November 14-20, 2022 is Thyroid Eye Illness Consciousness Week.

What’s 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 typically referred to as Graves’ ophthalmopathy or Graves’ Eye Illness. It is because 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.

When you have Graves’ illness, you’ve an elevated likelihood of creating thyroid eye illness. However TED is a uncommon illness and totally different from Graves’ illness and requires totally different therapy. Graves’ illness is the commonest explanation for hyperthyroidism, the place your physique produces an excessive amount of thyroid hormone. TED may happen with hypothyroidism, the place your physique produces too little thyroid hormone, however that is a lot much less widespread. When thyroid hormone ranges go up and down, it may well make your TED signs worse. Thyroid eye illness is extra widespread in ladies, 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 abruptly start to expertise signs. This section can final from about 6 months to 2 years. Throughout the inactive section, a lot of the signs are likely to get higher, however that is solely momentary. Scar tissue can kind within the eyelid and eye muscle through the inactive section.

What could make thyroid eye illness (TED) worse?

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

  • Smoking
  • Fluctuating hormones, reminiscent of in being pregnant
  • Stress
  • Eye trauma or surgical procedure
  • Different autoimmune circumstances reminiscent of Kind 1 diabetes, lupus or rheumatoid arthritis
  • Steroid use

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

TED is a critical illness that may worsen over time. Most individuals who’ve a thyroid situation reminiscent of Graves’ illness begin noticing eye signs inside the first 6 months. These signs can embody:

  • Dry, itching or gritty eyes
  • Eye tearing or redness
  • Ache 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 also have extra extreme signs reminiscent of 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 could have an effect on high quality of life as a result of it may well have an effect on your potential to drive, learn and work and may influence your emotional well-being.

How does thyroid eye illness (TED) get identified?

Generally your HCP could make a prognosis of TED based mostly in your signs alone. To get a prognosis of thyroid eye illness, you’ll need a bodily examination, in addition to an eye fixed examination. You may also have blood drawn to test the standing of your thyroid, together with imaginative and prescient checks and eyelid measurements.

It’d take visits to multiple HCP to get a TED prognosis. You could be referred to see an ophthalmologist who’s a physician that makes a speciality of eye and imaginative and prescient issues, 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 also be really useful that will help you handle your thyroid situation.

Generally the signs of TED reminiscent of dry, purple and irritated eyes may be mistaken for allergic reactions. Inform your HCP about all of your signs and medical historical past, so there may be not a delay in prognosis.

Managing thyroid eye illness (TED) signs

Whereas TED isn’t thought-about to be curable, there are remedies that may assist handle your signs. The longer that TED stays untreated, the extra seemingly critical harm can happen. Remedy is usually began within the acute section, however can nonetheless assist through the continual section.

At house, you should use cool compresses or lubricating eye drops to offer your dry or irritated eyes some aid. Sun shades might help defend your eyes from the solar and wind. To assist with the swelling and stress close to or in your eyes, strive sleeping along with your head elevated.

Sure drugs might help with eye swelling, reminiscent of steroid drugs. There are additionally newer prescription infusions accessible which will assist relieve signs.

In case your TED signs are extreme, your HCP may advocate you’ve surgical procedure. Orbital decompression may be carried out for those who’re experiencing bulging eyes. This surgical procedure helps make the attention socket larger to lower the stress in your eyes. Eyelid surgical procedure can 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’ll work with you to provide you with a therapy plan that can give you the results you want.

This useful resource was created with assist from Horizon.

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