People with an overactive thyroid (hyperthyroidism) are at risk for thyroid eye disease (TED), an autoimmune condition that affects the muscles and other tissues around the eyes. Thyroid eye disease also goes by other names, including thyroid-associated orbitopathy and Graves’ orbitopathy.
Symptoms of Thyroid Eye Disease
While some people with TED are asymptomatic, at least half report one or more of the following symptoms:
- Bulging eyes caused by swelling of the orbital tissues
- Inflammation of the eye and surrounding tissues
- Dry, itchy, or gritty eyes and difficulty wearing contact lenses
- Bloodshot eyes
- Increased tear production
- Double vision
- Light sensitivity
- Difficulty moving the eyes
- Pain when looking up, down, or to the side
- Vision loss
- Ulcerations on the cornea
Thyroid eye disease is known to fluctuate in severity over time. The active phase usually lasts two to three years, requiring careful monitoring by an ophthalmologist until the disease stabilizes or enters remission. Periods of remission may last six to 24 months. When TED has been inactive for at least six months, it’s less likely to recur.
Causes of Thyroid Eye Disease
TED often occurs in conjunction with Graves’ disease, an autoimmune condition that attacks the thyroid gland and leads to hyperthyroidism. About one-third of patients with Graves’ disease have symptoms of thyroid eye disease, and about 5% develop a severe case. Also, around 90% of patients with TED have hyperthyroidism.
Several risk factors besides Graves’ disease may contribute to thyroid eye disease, including:
- Genetics and family history
- Gender (women have a higher risk than men)
- First- and second-hand smoke
- Radioactive iodine treatment for Graves’ disease
- Advanced age
- High stress or trauma
- Poorly controlled diabetes
- Uncontrolled thyroid disease
Diagnosing Thyroid Eye Disease
If you have thyroid problems and begin experiencing symptoms involving your eyes, schedule a complete eye exam with an ophthalmologist. A CT scan or MRI may be needed to confirm the diagnosis. Also, if you exhibit signs of TED but have never had issues with your thyroid, a simple blood test can check your thyroid hormone levels.
Treating Thyroid Eye Disease
For mild cases, lubricating eye drops and artificial tears are usually effective. Apply a cool compress and elevate the head of your bed. Also, avoid windy conditions and exposure to bright light.
In severe cases, your healthcare provider may prescribe corticosteroids like prednisone to reduce swelling. A very small percentage of patients may require orbital decompression surgery.
In addition to treating thyroid eye disease directly, it’s also important to manage your overactive thyroid with beta-blockers, thioamides, and other medication. Thyroid surgery is another treatment option.
If you think you may have thyroid eye disease or have already been diagnosed, visit Eye Center of Northern Colorado for treatment. TED is one of our practice focuses, meaning you can expect the best possible care and relief from your symptoms. To schedule an appointment, please contact us in Fort Collins, Loveland, or Greeley today.