woman getting tested for thyroid eye disease after experiencing early TED symptoms

What Are the Early Signs and Symptoms of Thyroid Eye Disease?

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Raymond Douglas, MD PHD

Reconstructive & Aesthetic Oculoplastic Specialist

Thyroid eye disease (TED) can affect both the appearance and function of the eyes. Seen with thyroid disorders like Graves’ disease, TED symptoms can range from mild to severe vision loss if left untreated.

Knowing the early signs and symptoms is key to early intervention and proper treatment. Dr. Raymond Douglas is a dedicated expert in diagnosing and treating thyroid eye disease (TED), with years of experience helping patients navigate this challenging condition.

What is Thyroid Eye Disease?

Thyroid eye disease is an autoimmune disorder that affects people with thyroid conditions, most commonly Graves’ disease. In TED, the body’s immune system attacks the thyroid. This causes it to overproduce thyroid hormone which affects the tissues around the eyes and causes inflammation and swelling.

Even if you have mild TED, you can experience many symptoms. These range from mild irritation to more serious issues like bulging eyes or vision loss. TED often occurs with thyroid dysfunction, especially hyperthyroidism, but can also (rarely) occur in people with normal or low thyroid function. In reality, 90% of people with TED have hyperthyroidism.

How do you get tested for thyroid eye disease? Blood tests, medical history, CT scans, and sometimes MRIs.

How TED Affects the Eyes

TED is driven by an abnormal immune response that targets the thyroid. The overproduction of thyroid hormone affects the muscles and tissues around the eyes and causes inflammation and swelling.

These changes can affect both the appearance and function of the eyes, causing symptoms such as bulging eyes, limited movement, and even vision problems. In severe cases, the inflamed tissues can press on the optic nerve, causing pain and even permanent vision loss.

Early Signs of Thyroid Eye Disease

Knowing the early signs of TED is key to stopping progression. So, what are the first signs of thyroid eye disease?

Dry, gritty eyes

One of the first symptoms of TED is dryness and irritation in the eyes. Many people say it feels like sand or dust under their eyelids. Inflammation of the tear glands causes this dryness and prevents normal lubrication.

Redness and swelling of eyelids

TED causes inflammation of the eyelids, which causes redness and swelling. This is different from other eye conditions because the inflammation is specific to the autoimmune attack on the eye tissues.

Light sensitivity (photophobia)

Many people with TED experience light sensitivity (photophobia). This can make it hard to be in bright environments indoors and outdoors. Pain and discomfort often occurs. Wearing sunglasses can help reduce discomfort and sensitivity.

Watery eyes

While TED can cause dry eyes, it can also cause excessive tearing. This is because the eyes try to compensate for the irritation and dryness by producing more tears, which can increase the discomfort. It’s the same process that happens when dirt or grit is trapped under the eyelid, and the body tries to flush it out.

Visible Signs and Advanced Symptoms

As TED progresses, the symptoms become more evident and visible. The following are signs you are in advanced stages of the disease:

Bulging eyes (proptosis)

Proptosis or bulging eyes is perhaps the most visible sign of advanced TED. This happens when the tissues and muscles behind the eyes swell and push the eyeballs forward. Proptosis can affect both the appearance and function of the eyes. In severe cases the swelling and protrusion can be so bad the eyelids can’t close. This increases the risk of eye injury and corneal damage.

Double vision (diplopia)

TED often causes double vision (diplopia). Swelling of the eye muscles causes them to become misaligned and makes it hard to focus and see one clear image.

Eye pain or pressure

As the tissues behind the eyes become more inflamed, you may feel pressure or pain behind the eyes. This discomfort can be mild to severe and persistent.

Limited eye movement

Inflammation of the eye muscles restricts free movement and makes it hard to look in different directions. This often causes double vision and discomfort when focusing on objects.

Advanced Complications of TED

While most TED cases are mild, severe cases can lead to serious complications that need immediate medical attention:

Corneal ulceration

In severe cases of proptosis the eyes may not close fully during sleep and the cornea is exposed and more prone to ulcers. Corneal ulceration is very painful and can cause long term damage to the eye if not treated.

Vision loss

If TED is not treated, inflammation and pressure can cause permanent vision loss. This can happen due to damage to the cornea, optic nerve, or other parts of the eye.

Compression of the optic nerve

In rare cases, the swollen tissues behind the eyes can compress the optic nerve (the optic nerve transmits visual information from the eye to the brain). Compression can cause severe vision impairment or even blindness if not treated.

Female patients experience a broader range of thyroid eye disease symptoms.

When to Get Help

Early recognition of the warning signs of TED can make a big difference. Get medical attention if you have persistent discomfort, changes in vision or worsening of symptoms. Especially if you have bulging eyes, double vision or eye pain.

Early Detection Matters

Early detection is important in thyroid eye disease treatment. It gives more treatment options to slow down or stop the disease from progressing. In addition to managing the underlying thyroid disorder, targeted therapies can reduce inflammation and prevent long-term damage.

Why You Should See a Specialist

Given the complexity of TED, it’s best to work with a specialist who has experience in treating this condition. Dr. Raymond Douglas is a leading expert in thyroid eye disease management and sees patients with the condition. Dr. Douglas works with endocrinologists and ophthalmologists to help you navigate the TED maze.

Call Dr. Raymond Douglas Now!

If you or someone you know has symptoms of thyroid eye disease, seek medical advice. Dr. Raymond Douglas and his team provide personalized diagnosis and treatment for TED. Call Dr. Douglas today to schedule a consultation. 

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