Have you ever squinted at a brightly lit room or shied away from a sunny day, feeling your eyes were under siege? For people with thyroid eye disease (TED), light sensitivity is more than an occasional annoyance; it can be a painful daily struggle, disrupting work, personal relationships, and simple pleasures like enjoying a bright, beautiful day outdoors.
Photophobia—light sensitivity’s fancy name—affects 90% of people with TED and it can be exhausting to deal with. Imagine stepping outside, and the sunlight feels like an interrogation spotlight, or the glow of your computer screen is as offensive as a camera flash. Those with TED often squint in pain, tear up, and dodge lights.
What if there was a treatment that tackles the symptoms and the underlying cause of TED-related photophobia? Teprotumumab is hailed as a groundbreaking thyroid eye disease medication, relieving debilitating light sensitivity.
Understanding Light Sensitivity in Thyroid Eye Disease
Thyroid eye disease is an autoimmune disorder caused by a weakened immune system attacking the fragile tissues around the eyes. This leads to severe inflammation, extreme puffiness, bulging eyes, double vision, symptoms of dry eyes and light sensitivity.
The condition can be extremely painful, and may lead to social isolation due to the dramatic facial changes and often disrupts someone’s quality of life. Everyday tasks feel impossible, and many people resort to staying home or wearing sunglasses to reduce bright lights but also to hide the eyes.
Photophobia occurs for various reasons, but eyelid retraction, which is the most common finding in TED, causes the eyelids to open wider and creating the classic ‘stare’ appearance and making light sensitivity worse. Thyroid eye disease can also cause instability of the tear film, when coupled with increased exposure of the eye surface, leads to dry eyes that may intensify sensitivity.
For many patients, TED-related photophobia feels like a relentless, painful glare—a disruptive symptom that sunglasses can’t fix.
The Science Behind Thyroid Eye Disease and Inflammation
At the root of TED lies an overactive immune response. The immune system produces autoantibodies targeting the thyroid and the fibroblasts in eye tissues. While the reasons are unknown, this triggers an inflammatory reaction, causing swelling, fibrosis, and fat and muscle expansion in the orbital socket.
As thyroid eye disease progresses, the inflammation worsens and damages the eyes, causing physical changes like bulging, eyelids that don’t close completely, inflammation of the tear producing gland, and dry eyes. These changes heighten sensitivity to light, leaving TED patients feeling trapped in a perpetual state of discomfort.
What is Tepezza® (Teprotumumab)?
Teprotumumab is a monoclonal antibody therapy considered a trailblazing infusion treatment for TED-related photophobia. Approved by the FDA in 2020 under the brand name Tepezza®, it targets and inhibits the insulin-like growth factor-1 receptor, which plays a key role in the autoimmune and inflammatory processes underlying TED.
Simply put, teprotumumab shuts down the immune system’s attack response to reduce inflammation and prevent worsening symptoms. The medication takes a significant shift from traditional thyroid eye disease treatments like invasive surgeries and nonspecific antiinflammatory medications.
How Does Tepezza® (Teprotumumab) Address Light Sensitivity?
One of the most exciting aspects of teprotumumab is its ability to reduce swelling and inflammation, directly lessening light sensitivity. The medication can improve the function of the cornea and tear glands, restoring necessary lubrication to keep eyes healthy and pain-free.
For patients who’ve suffered from long-term, persistent photophobia, the relief can be life-altering. Many report that bright lights no longer feel as harsh and glaring. Those with thyroid eye disease can enjoy everyday activities without squinting or shielding their eyes.
In randomized, double-blind clinical trials of teprotumumab, a majority of participants experienced reduced eye bulging. According to studies by Raymond Douglas, 50% of patients receiving teprotumumab saw significant photophobia relief in 6 weeks. For many, this was the first time in years that their eyes had felt relief from constant pressure and pain.
When Should Tepezza® (Teprotumumab) Be Considered for Thyroid Eye Disease?
A teprotumumab-trbw works best during the “active” phase of thyroid eye disease; This is when inflammation is at its worst, making it the perfect time for medical professionals to intervene to stop the damage before it becomes permanent. Not to worry if you have had longstanding disease though – more recent studies have shown that teprotumumab can be effective in people who have been living with TED for years.
If your eyes feel dry, irritated, uncomfortable, if you have pressure behind the eyes or you’re dealing with severe thyroid eye disease symptoms like bulging eyes, double vision, it may be time to contact a doctor about teprotumumab. They can help you weigh the benefits, risks, and timing to determine what the best treatment option is for you.
Managing Your Symptoms
In addition to adding teprotumumab to your TED care plan, you can take the following steps to manage and ease light sensitivity.
These little tweaks can make a significant difference in your everyday comfort from your eye symptoms, including:
- Upgrade your sunglasses. Heavy materials can worsen inflammation, so opt for lightweight frames with polarized lenses that offer complete UVA and UVB protection.
- Moisturize your eyes. Use high-quality artificial tears for dry, irritated eyes.
- Make your home comfortable. Swap harsh lights for a softer, warmer glow, and avoid LEDs that could be like having a second sun in your home.
- Limit screen time. Staring at the bright lights on a screen for too long can cause dryness and increased swelling.
Potential Teprotumumab Side Effects
As much as healthcare professionals would love for teprotumumab to be all upside, there are some potential side effects to consider. The most common ones include nausea, muscle cramps, and exhaustion or chronic fatigue. In rare cases, patients may experience hearing issues or elevated blood sugar levels.
The good news is that these side effects are often temporary and manageable. Most patients find relief from TED symptoms like photophobia well worth the trade-off. In rare cases, patients may experience hearing changes that are not reversible, but this is usually in patients with pre-existing hearing problems and your physician should screen for this in advance.
The Future of Thyroid Eye Disease Healthcare: Innovations and Hope
Teprotumumab is cited as a revolutionary medication for thyroid eye disease-related light sensitivity, but it’s only the beginning of TED treatment. We are at the early stages of a new era in the treatment of TED, and researchers are exploring novel treatment options and new treatment pathways that may help to better tailor and personalize treatment in the future.
The goal is to make thyroid eye disease entirely treatable, with minimal side effects and maximal relief. Teprotumumab is leading the way, allowing patients to relieve their pain, take back their lives, and enjoy sunny days.
Contact Dr. Raymond Douglas, a thyroid-associated ophthalmopathy doctor, today for more information about our health treatments for TED and Graves’ disease.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232498/
https://pmc.ncbi.nlm.nih.gov/articles/PMC7640822
https://iovs.arvojournals.org/article.aspx?articleid=2776158&utm
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