What Triggers Thyroid Eye Disease?

What Triggers Thyroid Eye Disease?

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Raymond Douglas, MD PHD

Reconstructive & Aesthetic Oculoplastic Specialist

Thyroid eye disease (TED), sometimes called Graves’ orbitopathy or ophthalmopathy, is a complex autoimmune condition that affects the eyes. If you or someone you know has thyroid problems, you might already be familiar with their impacts on different areas of the body. 

TED specifically affects the tissues around the eyes. It causes symptoms like swelling, eye bulging, and even vision changes. Understanding what triggers thyroid eye disease can help you manage and potentially prevent the condition from worsening.

Understanding Thyroid Eye Disease

Thyroid eye disease is closely linked to thyroid disorders, especially an overactive thyroid condition known as Graves’ disease. TED occurs when the immune system mistakenly targets the muscles and connective tissues around the eyes, causing inflammation and other symptoms. 

This immune response leads to a range of issues, such as: 

  • Bulging eyes
  • Double vision
  • Redness
  • Vision loss

Knowing what triggers thyroid eye disease can help you recognize the signs early and seek the right care before symptoms progress.

Key Triggers of Thyroid Eye Disease

What triggers thyroid eye disease? TED doesn’t develop out of nowhere. Several key factors contribute to the onset of TED, including autoimmune reactions, hormonal shifts, environmental influences, and even genetic tendencies. Let’s take a closer look at each of these triggers.

Autoimmune Factors

Thyroid eye disease is an autoimmune disorder, meaning your immune system mistakenly attacks its own tissues. Graves’ disease (another autoimmune condition where the immune system stimulates the thyroid gland) often triggers TED, leading to an overproduction of thyroid hormones. 

This heightened immune response doesn’t stop at the thyroid. It can also extend to the eye area, causing TED symptoms. If you have Graves’ disease, you may have a higher chance of developing TED, as the same antibodies that affect the thyroid can also target the eyes.

Hormonal Changes

When it comes to what triggers thyroid eye disease, hormonal fluctuations, especially thyroid hormone variations, play a big role. Hormonal changes can increase immune activity, worsening inflammation around the eyes. If your thyroid hormone levels aren’t balanced, whether due to hyperthyroidism or other hormonal issues, you may be more susceptible to TED.  

Monitoring and managing hormone levels is important for people at risk of TED, as even small changes can lead to eye-related symptoms. Thyroid hormone checks should be part of your annual wellness checkups, particularly if you’re at risk for developing TED.

Environmental Factors

What triggers thyroid eye disease? It might be things outside your body. Certain environmental factors, like smoking and radiation exposure, have been linked to an increased risk of developing TED. Smoking, in particular, is a major risk factor. It can increase both the severity and likelihood of TED. 

Studies have shown that smokers with Graves’ disease are significantly more likely to develop TED than non-smokers. Ex-smokers also have an increased risk of developing TED, but their risk is much lower than current smokers. 

If you smoke, quitting now is the best option. One study found that those who quit smoking a year before developing orbital involvement had a lower risk of ophthalmic involvement than those who continued to smoke.

Genetic Predisposition

Genetics can play a significant role in how likely you are to develop TED. If you have a family history of autoimmune diseases, especially thyroid-related conditions, your chances of developing TED are likely higher than someone without that genetic contribution. 

Genetics alone don’t cause TED, but a genetic predisposition can make you more vulnerable to the other triggers that lead to TED, like hormonal changes and autoimmune responses.

Recognizing Early Signs of Thyroid Eye Disease

The earlier you catch the symptoms of TED, the easier it is to manage the condition. So, what are the first signs of thyroid eye disease? TED often begins with mild symptoms, like dryness or irritation in the eyes. 

Eventually, you may notice swelling around the eyes, redness, or a feeling of grittiness. As the condition progresses, more noticeable symptoms appear, like bulging eyes (proptosis), double vision, and even pain when moving the eyes. 

If you’re those early symptoms sound familiar, take action sooner rather than later. It’s entirely possible to prevent more severe complications.

Stages of Thyroid Eye Disease

TED progresses through two main stages: the active stage and the inactive stage. It’s important to understand both and what they mean for you.

Active Stage

During the active stage, symptoms such as swelling, pain, and eye bulging are at their peak. The inflammation around the eyes is high, leading to uncomfortable symptoms. This stage can last anywhere from a few months to over a year.

Inactive Stage

In the inactive stage, inflammation reduces, and symptoms stabilize. However, some may not disappear even after the active stage passes, like bulging eyes. While the disease slows, you may still need treatment to manage those issues.

Diagnosis and Testing

If you suspect you or someone you love might have TED, it’s important to know how to test for thyroid eye disease. 

Doctors use a combination of physical examinations, imaging, and blood tests to diagnose TED. An eye specialist might check for inflammation and eye movement issues. Blood tests can reveal thyroid hormone levels, while imaging tests like CT scans or MRIs offer a detailed view of the tissues around the eye, helping doctors assess the extent of inflammation and any damage.

Treatment Options for Thyroid Eye Disease

Once diagnosed, you can use several methods to manage TED. These can range from medications for inflammation to more advanced therapies for severe cases. Here are some common approaches:

  • Anti-inflammatory Medications: Corticosteroids help reduce inflammation and relieve swelling during the active stage.
  • Immunosuppressive Therapy: Specific medications help suppress immune activity around the eyes, reducing your symptoms.
  • Surgery: In severe cases, orbital decompression surgery may be needed to relieve pressure and improve vision.

Managing TED involves addressing its triggers. For example, if you’re a smoker, quitting can significantly reduce symptom severity. Balancing thyroid hormone levels can help stabilize the immune response and prevent the worsening of TED symptoms.

Contact Dr. Raymond Douglas for Expert Care

If you suspect you might have thyroid eye disease or want to explore treatment options, consulting an expert can make all the difference. Dr. Raymond Douglas specializes in personalized care for TED, offering a tailored approach to each patient. Don’t wait for symptoms to worsen—reach out to Dr. Douglas today to get the evaluation and support you need.

Schedule a consultation with Dr. Raymond Douglas to take the first step toward managing thyroid eye disease and improving your eye health.

Source:

https://www.healthline.com/health/faqs-thyroid-eye-disease-diagnosed
https://www.endocrine.org/patient-engagement/endocrine-library/thyroid-eye-disease
https://pmc.ncbi.nlm.nih.gov/articles/PMC10676518

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