Inflammation and damage to the tissues around your eyes are symptoms of thyroid eye disease (TED), an inflammatory illness that affects the thyroid gland. The active phase and the inactive phase are the two stages that make up the TED process.
Thyroid Eye Disease
Within the active period, there is a gradual increase in edema as well as alterations in the ocular tissue. It is during the inactive phase that the course of the illness slows down and finally ceases; nevertheless, the damage that was caused during the active phase continues to develop. Between six months and two years is the range of time that the active phase may endure.
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Those who suffer from Graves’ disease, a disorder that manifests itself when your thyroid glands create an excessive amount of thyroid hormone, are the most likely to suffer from thyroid eye illness. TED may also develop in persons who do not have an underlying thyroid condition, but this is a less common occurrence.
Symptoms of Thyroid Eye Disease
The severity of the symptoms of TED may range from moderate to severe, and they can also differ from one individual to the next. It is quite likely that you will have symptoms in both of your eyes. However, it is possible that one eye may have more severe symptoms than the other.
Common symptoms of thyroid eye disease include:
- Eye redness
- Irritation in the eyes
- Dry eyes
- Bulging eyes
- Double vision
- Watery eyes
- Swollen eyelids
- Pain during eye movements
- Difficulty seeing bright lights
- Discomfort or pain behind the eyes
When the swelling is severe enough, it may cause your eyes to be subjected to an excessive amount of pressure, which can ultimately lead to the compression of the optic nerve. The optic nerve is the primary nerve in the eye that, in order to facilitate vision, transmits impulses from the visual nerve to the brain. It is possible for this illness to cause gradual vision loss if it is not treated in the appropriate manner.
Causes
When you have thyroid eye disease, you have an autoimmune illness, which means that your immune system starts attacking healthy tissues in your body without your knowledge. When it comes to the majority of autoimmune disorders, experts do not yet have a clear understanding of the specific reason.
Graves’ illness is characterized by the development of an aberrant antibody called thyroid-stimulating immunoglobulin by the immune system. This antibody mimics the activity of thyroid-stimulating hormone (TSH), which is a hormone that plays a role in the regulation of metabolism.
Considering that the tissues surrounding the eyes are composed of proteins that are comparable to those present in the thyroid gland, these aberrant antibodies also have an effect on the tissues that surround the eyes.
It should be brought to your attention that not all people who have thyroid eye illness also have Graves’ disease. It seems from this that thyroid eye illness may also be caused by other different reasons. To name a few of the factors that might make you more susceptible to developing this condition:
- Being assigned female at birth
- Having a family history of TED
- Smoking cigarettes or using other tobacco products
- Undergoing radioactive iodine therapy
- Existing with preexisting medical disorders, such as rheumatoid arthritis or type 1 diabetes, among other conditions
Diagnosis
If you are having symptoms of thyroid eye disease (TED) or if you have an underlying thyroid issue, it is essential that you see your primary care physician for support and your eye care professional (such as an optometrist or ophthalmologist) for testing.
During your meeting with your eye care professional, they will inquire about your symptoms as well as your personal and family medical history. In addition to that, they will do a full physical examination. The following are some of the further tests that your eye care professional could prescribe after this:
- Eye bulging test: This instrument, known as an exophthalmometer, is used to determine the degree to which your eyes are swollen.
- Color vision test:Â Tests your ability to distinguish different colors
- Visual field test:Â Determines if you have blind spots (areas where you are unable to see)
- Imaging tests: The purpose of imaging procedures like computed tomography (CT scan) and magnetic resonance imaging (MRI) is to discover swelling around your eye tissues and optic nerve by taking comprehensive pictures of your eye sockets and muscles.
If you do not presently have a diagnosis for Graves’ disease or any other underlying thyroid disorders, your eye care specialist may also recommend you to an endocrinologist, which is a doctor who specializes in hormonal conditions, in order to have your thyroid levels tested.
This is particularly the case if you want to have your thyroid levels evaluated. In order to confirm the diagnosis of thyroid eye illness, an endocrinologist would most likely analyze the patient’s blood in order to examine the levels of thyroid hormone or to assess antibodies.
Treatment
Reversing the underlying thyroid problem is often a part of the treatment for thyroid eye illness, particularly in cases when Graves’ disease is associated with the condition. It is important to keep in mind that treating Graves’ illness does not usually entirely eliminate symptoms of TED, but it may assist you in better managing the condition.
At-Home Remedies
The following treatment methods may be recommended by your eye care professional for mild instances of transient ocular deceleration (TED):
- For the purpose of alleviating dry eyes, the use of lubricating eye drops or artificial tears
- Applying cold compresses to the eyes in order to alleviate discomfort and edema around the eyes
- For the purpose of preventing light sensitivity, wearing sunglasses
- You should give up smoking since it might make the symptoms of TED worse
Medications
In the event that your problem is more severe, your healthcare team, which may include of your primary care physician, endocrinologist, and eye care expert, may suggest that you have surgery or take medication. A number of medicines are often recommended for TED, including:
- Tepezza (teprotumumab): An injection administered intravenously (IV) that has the potential to alleviate eye discomfort and swelling
- Rayos (prednisone): A corticosteroid medication that has the potential to reduce edema in the eyes
Surgery
In the event that you are experiencing severe symptoms of TED, your healthcare staff may only propose surgery to you. During the dormant phase of the disorder, when symptoms are at their lowest, your care team will often conduct surgery on you if it is a viable choice for you to undergo surgical intervention.
In the event that you are at danger of losing your eyesight during an active period, you may need surgical intervention. There are a variety of surgical procedures that may be performed to treat TED, and the specific operation that you need will be determined by the severity of your problem. Here are some options:
- Orbital decompression surgery: Offers assistance in reducing eye bulging and improving vision issues in cases when the optic nerve is squeezed.
- Eyelid surgery:Â Repositions your eyelid to reduce irritation
- Eye muscle surgery: Identifies and eliminates the possibility of double vision that may be brought on by thyroid eye problems
How To Prevent Thyroid Eye Disease
There are few preventative measures available for thyroid eye disease (TED) due to the fact that it is an autoimmune disorder. Nevertheless, if you stop smoking, restrict your exposure to secondhand smoke, and steer clear of iodine treatment, you may be able to reduce your chance of developing this illness.
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Complications
It is really necessary to acquire the appropriate therapy for TED. It is possible for thyroid eye illness to result in major problems if it is not addressed. A few examples of these difficulties are as follows:
- Optic atrophy: Reduces the size of the optic nerve and hence leads to severe visual impairments
- Exposure-keratopathy: This condition, which is often brought on by an inability to correctly close the eyelids, causes damage to the cornea and produces dry eyes
- Persistent proptosis: This condition causes the eyes to continue to protrude, which may result in irreversible alterations to the look of the eyes and the face as a whole
- Open-angle glaucoma: Causes a decrease in vision or perhaps blindness as a consequence of injury to the optic nerve
Living With TED
When it comes to thyroid eye illness, the severity of the condition differs from person to person. During the inactive period, swelling is often reduced and the growth of the illness is slowed down. The active phase may continue anywhere from six months to two years.
The majority of individuals suffer from moderate instances of thyroid eye disease, which may be remedied on their own with home treatments. To address the illness, medication or surgery is only necessary for five to twenty percent of the population.If you want to find out which treatment methods are most suitable for you, the best people to inform you about your alternatives are the members of your healthcare team.