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 Disease Awareness Week.

What’s thyroid eye illness (TED)?

Thyroid eye illness, or TED, is an autoimmune dysfunction that causes irritation within the eye muscle tissue, eyelids, tear glands and fatty tissues behind the attention. TED is usually 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’ve got Graves’ illness, you will have an increased chance of creating thyroid eye illness. However 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 may also happen with hypothyroidism, the place your physique produces too little thyroid hormone, however that is a lot much less widespread. When thyroid hormone levels go up and down, it may make your TED signs worse. Thyroid eye illness is more common in women, however is commonly 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 power). 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. In the course of the inactive section, many of the signs are likely to get higher, however that is solely momentary. 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?

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

  • Smoking
  • Fluctuating hormones, resembling in being pregnant
  • Stress
  • Eye trauma or surgical procedure
  • Different autoimmune situations resembling Sort 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 resembling Graves’ illness begin noticing eye signs throughout the first 6 months. These signs can include:

  • 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 resembling not having the ability to transfer your eyes or eyelids properly, not having the ability to utterly shut your eyes or, in uncommon circumstances, lack of imaginative and prescient. This may have an effect on high quality of life as a result of it may have an effect on your skill to drive, learn and work and may impression your emotional well-being.

How does thyroid eye illness (TED) get identified?

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

It would take visits to multiple HCP to get a TED analysis. You could be referred to see an ophthalmologist who’s a health care provider 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 health care provider that treats hormone points, may also be beneficial that will help you handle your thyroid situation.

Typically the signs of TED resembling dry, pink and irritated eyes could 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 analysis.

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 doubtless critical harm can happen. Remedy is commonly began within the acute section, however can nonetheless assist in the course of the power section.

At dwelling, you should use cool compresses or lubricating eye drops to provide your dry or irritated eyes some aid. Sunglasses will help defend your eyes from the solar and wind. To assist with the swelling and stress close to or in your eyes, attempt sleeping along with your head elevated.

Sure drugs will help with eye swelling, resembling steroid drugs. There are additionally newer prescription infusions out there which will assist relieve signs.

In case your TED signs are extreme, your HCP may advocate you will have surgical procedure. Orbital decompression could be carried out if you happen to’re experiencing bulging eyes. This surgical procedure helps make the attention socket greater to lower the stress in your eyes. Eyelid surgery will also be carried out in case your eyelids have pulled again an excessive amount of. This helps return them again to their regular place.

In case you are involved that you just may need thyroid eye illness, speak along with your HCP. They’ll work with you to provide you with a remedy plan that may be just right for you.

This useful resource was created with assist from Horizon.

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