The thyroid is a butterfly-shaped gland in the neck. It produces hormones that regulate metabolism, body growth and development, calcium usage, and heart rate.
But autoimmune conditions like Graves’ disease can go wrong. Graves’ disease is also known as thyroid eye disease (TED) or Grave’s ophthalmopathy. It can change your eye appearance and your vision.
The American Thyroid Association defines thyroid eye disease as “an autoimmune disease that affects some people with autoimmune thyroid disease. TED is most common in people with hyperthyroidism due to Grave’s disease and rarely in people with normal or low thyroid levels.”
How Does the Thyroid Affect the Eyes?
The thyroid controls a wide range of metabolic functions, including how the body turns food into energy, how calcium is metabolized in the body, and more. It also controls body temperature and heart rate.
Grave’s disease causes the body’s immune system to attack the thyroid. In response, the thyroid starts to overproduce thyroid hormone (hyperthyroidism). This leads to swelling (inflammation) around the eye and, eventually, damage to the connective tissue, muscles, and fatty tissue.
Symptoms of Thyroid Eye Disease
What are the first signs of thyroid eye disease? Knowing thyroid eye disease symptoms will help you identify early signs and symptoms of more advanced conditions. But remember, symptoms can vary from person to person.
Early signs
Some of the first signs of thyroid eye disease are dry, red, irritated eyes. However, these can also be symptoms of other conditions, from exposure to common allergens to not getting enough sleep.
Moderate signs
As thyroid eye disease progresses, symptoms can get worse. Moderate symptoms are swelling around the eyes, double vision, and bulging eyes (exophthalmos). Many of these changes are directly related to how too much thyroid hormone affects the muscles in the body. For example, inflammation in the muscles around the eye causes it to bulge forward. It’s also responsible for double vision and damage to the optic nerve.
Advanced signs
In advanced stages of thyroid eye disease symptoms include pain, limited eye movement and vision loss. As the muscles swell they restrict eye movement and can even stop the lid from closing. Inflamed muscles pressing on the optic nerve cause damage and can lead to vision loss.
Who is at Risk of Developing Thyroid Eye Disease?
Now that we know the symptoms of thyroid eye disease, let’s look at the risk factors. Who’s most likely to get it in the first place? If you have Graves’ disease, you’re likely to get thyroid eye disease. If your thyroid is overproducing hormones due to another condition, you’re also at risk of getting TED, but medical treatment can reduce that risk. Other risk factors are:
- Smokers
- Family history of TED
- Female (women get TED more often than men)
How is Thyroid Eye Disease diagnosed?
The first step in any treatment of thyroid eye disease is a correct diagnosis. First a medical practitioner will go over your medical history including your family history. You’ll also have a physical examination and diagnostic tests. Early detection and regular monitoring is key to good outcomes. Late detection and/or no monitoring can allow the disease to progress and result in vision loss and pain.
Tests
Diagnostic tests will provide more information for a diagnosis. Your doctor will order blood tests to check thyroid function (thyroid hormone level in your blood). You may also need a CT scan. In some cases, your doctor may need an MRI of your eyes to get a closer look at the muscles and other soft tissues and check for inflammation.
Stages of Thyroid Eye Disease
There are two stages of thyroid eye disease: active and inactive.
Active stage
The active stage of the disease is characterized by increasing inflammation and swelling around the eyes. During this stage, you will notice rapid changes in the appearance and function of your eyes. This is also called the “sight-threatening” stage because you can develop dysthyroid optic neuropathy (a common cause of vision loss in TED patients) or keratopathy (a condition that can lead to corneal ulcers and permanent vision loss). The active stage can last from 6 months to 2 years.
Inactive stage
Once diagnosed, your doctor can treat you, and you should enter the inactive stage. During this stage your symptoms should stabilize, but you may not see full reversal of the effects. The inactive stage can be interrupted by TED flares.
Living with Thyroid Eye Disease
Can thyroid eye disease be cured? The short answer is no. However, it can be managed well with regular monitoring and proactive care during the active stage and during flares. There are also many things you can do to help yourself with the disease, including:
- Wearing sunglasses to help with sensitivity
- Using eye drops to moisturize and treat symptoms
- Sleep adjustments to help you rest and recover
You’ll need to have regular eye exams to monitor your TED symptoms. You’ll also need to work with both ophthalmologists and endocrinologists to coordinate both sides of the treatment.
Don’t underestimate the emotional and psychological impact of TED. Physical changes can affect your appearance, and vision issues can affect your vision. And that can affect your quality of life, depression, and other negative outcomes. Having an understanding care team and supportive friends and family can help.
Get in Touch with Raymond Douglas Today
Thyroid eye disease is a serious condition that can cause pain, physical changes to the face and eyes, and even permanent vision loss. Do you know someone who may be at risk of TED? Share this to help them get the information they need.
Experiencing TED symptoms? Talk to a healthcare provider at Raymond Douglas today.