Thyroid Eye Disorders
A systemic disease is one that affects multiple organs within the body. This can include the eyes. Thyroid eye disease (TED) is one such disease that causes an inflammatory response in the eyes and surrounding tissues. TED is also known by other names, including thyroid orbitopathy or Graves’ ophthalmopathy.
TED is an autoimmune reaction that causes the eye tissues—the eye muscles, tear glands, eyelids, and fatty tissue—to swell. This pushes the eyes forwards and they become red, swollen, and uncomfortable. They also take on a bulging or staring appearance. In some cases, the symptoms are so severe that the eyes can no longer move in line with each other.
As well as the eyes, around 90% of sufferers also have a disease that affects the thyroid gland. This is known as Graves’ disease. This tends to be when the thyroid is overactive—known as hyperthyroidism. But rarely it can cause the gland to become underactive (hypothyroidism). TED can also occur in people with a normally functioning thyroid.
Because of the complexity of the condition, those who suffer from thyroid eye disease need to have a treatment plan served by both an ophthalmologist (specialist eye doctor) and an endocrinologist (thyroid specialist).
How Do I Know If I Need an Ophthalmologist Specializing in Thyroid Eye Disease Near Me?
Thyroid eye disease is often misdiagnosed at first. This is due to some of the symptoms being very similar to other conditions, such as hay fever, allergies, or conjunctivitis. Because TED can have a significant impact on a sufferer’s quality of life, expert treatment should be sought at an early stage to determine the problem.
Thyroid eye disease, along with other systemic eye diseases, is best diagnosed by a specialist service. An easy way to find a local provider is to enter “eye disease specialist near me” or “eye disease doctor near me” into any search engine. This will bring up a list of those in the vicinity. However, depending on the severity of the condition, you may consider traveling to take advantage of some of the more cutting edge treatments only available from the most advanced eye practitioners.
Symptoms that might alert you to seek advice from an ophthalmologist specializing in thyroid eye disease include:
- Changes in the appearance of the eyes: Bulging or staring
- Swelling: Both the upper and lower eyelids can be affected
- Pain: Behind or in the eye. This can be more apparent when looking down, up, or to the side
- Dry or gritty eyes
- Difficulty in moving the eyes
- Redness: In the eyes themselves and/or around the lids
- New bags under the eyes
- Photophobia: An intolerance of bright light
- Blurred vision: Including double vision
- Watery eyes
- Headaches: As the swelling increases this can cause pressure pain or a deep headache. It typically worsens when you move your eyes
What Happens During Thyroid Eye Disease Treatment?
There are various treatments for thyroid eye disease, ranging from drug therapy to surgical intervention. The most suitable for your condition will depend on many factors and will be agreed on through discussion with you and collaboration between your ophthalmologist and endocrinologist.
TED follows a 2-phase disease course. The first is known as the active stage, where the symptoms will worsen, before waning and entering stage 2, the more stable phase. Stage 1 typically lasts for anything from 1-3 years (it lasts longer in those who smoke), after which the condition stabilizes. Early treatment is key to reducing the severity of the symptoms.
Treatment options include:
- Gaining normal systemic thyroid hormone levels: Various drugs are used to regulate the production of the thyroid hormones. Other options include radioactive iodine ablation or a thyroidectomy.
- Steroid treatment: To reduce inflammation and swelling of the eye tissues. This can be through oral steroids (such as prednisone) or, if this is ineffective, intravenous steroid treatment.
- Orbital radiotherapy: Usually used in combination with steroid treatment, this involves targeting the tissue behind the eyeball with a controlled beam of radiation to decrease the orbital pressure.
- Surgical orbital decompression: If the swelling becomes too severe it can cause pressure on the optic nerve. There are many different approaches to the procedure, all aimed at relieving pressure on the optic nerve and blood supply.
- Treatment of eyelid retraction: This can be treated non-surgically (through steroid injections, fillers, or Botox) or with surgery to relieve tension. One such treatment is a blepharotomy. This involves a small incision being made in the eyelid to help it lengthen and close correctly.
- Strabismus correction: Strabismus (crossed eyes) can occur from the swelling and tightness of the eye muscles. It’s generally treated with prism lenses. However, if these are not suitable or unsuccessful. then surgical intervention might be needed. Botox injections are also used in some cases.
How Can A Thyroid Eye Disease Specialist Near Me Help With This Condition?
During both the acute and stable phases of thyroid eye disease, it’s essential to have regular assessments/treatment. Although it’s rare for TED to cause permanent vision problems, if left untreated this becomes more of a possibility.
There’s no doubting that thyroid eye disease can be a life-debilitating condition. Symptoms like double vision, developing ulcers around the eye if the eyelid can’t close properly and, in untreated and severe cases, optic nerve compression can cause loss of vision. Early intervention is key to managing the condition.
As well as being able to prescribe medication and/or carry out any necessary surgical procedures, a specialist will advise on other aspects that have a direct impact on the severity and progression of the disease. These include:
- Stopping smoking: Smokers are far more adversely affected by TED than non-smokers. Not only are they more likely to suffer in the first place, but the condition lasts for longer, symptoms are more pronounced, and the risk of permanent vision damage is higher.
- Other lifestyle modifications: Such as reducing your salt intake, sleeping in a position where your head is elevated, wearing sunglasses, and taking a supplement of Selenium.
- Dry eye management: You may be prescribed drops or ointment to help keep the eyes moist.
- Pain relief: Either over-the-counter drugs or prescription analgesia.