There are many different structures within and around the eye. Each plays an important role in the clarity of your vision, as well as your ability to move your eyes comfortably. Thyroid eye disease, which is also known as TED is an inflammatory condition that affects the eye muscles and the fatty tissues behind your eyes.

Left unchecked thyroid eye disease can cause the eyes to bulge or be pushed forward. As this continues to happen the eyes and eyelids become increasingly swollen and red. With some of these cases, the stiffness and localized swelling in the muscles that move the eyes can cause the eyes to no longer be in line with each other, leading to issues with double vision. It’s also worth noting that thyroid eye disease can potentially apply enough pressure on the nerve at the back of the eyes that it causes eye ulcers and can eventually lead to blindness.

It is technically an autoimmune disease that causes your body’s own immune system to attack the back of the eye leading to worsening problems with inflammation. This condition is typically associated with Grave’s disease which causes an over-active thyroid. However, it does sometimes occur in people with a normally functioning thyroid.

How Common Is Thyroid Eye Disease

Statistically, around 25% of people with Graves’ disease will also develop thyroid eye disease before, during, or even after diagnosis. Most of the time, the symptoms are mild. If you are a non-smoker and you have no symptoms of thyroid eye disease at the time of your Graves’ disease diagnosis, your risk for developing thyroid eye disease decreases to 10%. However, smokers have a much higher chance of developing thyroid eye disease.

What Are The Most Common Symptoms Of Thyroid Eye Disease?

  • A slight to moderate bulging appearance of the eyes
  • A gritty feeling in the eyes
  • Problems with watery or dry eyes
  • Light sensitivity
  • Swollen eyelids
  • Bags developing under the eyes
  • Redness of the eyes and eyelids
  • Blurry or even double vision
  • Feeling pain in or behind the eyes when looking up, down or side to side

Some cases of thyroid eye disease can be difficult to diagnose and may be masked as conjunctivitis, an allergy affecting the eyes. Sometimes it can take several months before an accurate diagnosis can be made.

What Is The Impact Of Smoking?

Most smokers are aware of the adverse effects imposed on their respiratory and cardiovascular health. However, it can also have a profound negative impact on eye health and can also increase your chances of developing as well as complicate treatment of thyroid eye disease.

Even if you consider yourself to be little more than a recreational or occasional smoker, you should still make every effort to quit. Patients with thyroid eye disease who continue smoking tend to have lower success treatment rates. Yet this problem also tends to improve shortly after embracing total cessation. It’s also worth bearing in mind that non-smokers and former smokers are more likely to be cured of thyroid over-activity problems through a course of Carbimazole or Propylthiouracil treatment.

What Should I Do If I Have Been Diagnosed With Grave’s Disease?

If you have recently been diagnosed with Grave’s disease or you have been dealing with it for a prolonged period of time, it’s best to avoid fluctuations in your thyroid levels. It’s wise to have thyroid blood tests performed regularly, and follow your doctor’s advice, including making sure to take your medications as directed. This helps to ensure that your thyroid levels remain normal and consistent to give your eyes the best chance of healing.

There is also a growing body of research that suggests selenium supplements may help patients with mild thyroid eye disease. These studies suggest that a six-month course of selenium supplements that includes consuming 100mcg twice a day may help speed the healing process.

What Is The Treatment Time Table For Thyroid Eye Disease?

Most patients with mild thyroid eye disease complain that their eyes feel gritty and tend to water a lot. Many also struggle with light sensitivity. In cases like this, artificial tear drops may help your eyes feel comfortable. Again, selenium supplements taken at 100mcg twice daily for six months may also help ease thyroid eye disease discomfort.

You should speak to your endocrinologist if you have other symptoms of thyroid eye disease in conjunction with a Grave’s disease diagnosis. In many of these cases, they will likely refer you to an eye doctor.

The course of treatment may take some time to start improving symptoms. For some patients, it can take between 6 to 12 months for inflammation to decrease and improve comfort in the eyes. This time frame might also be longer if you are a smoker.

For some people with thyroid eye disease, the change in the eyes is permanent or their eyes will not completely revert to normal. This can also lead to lingering problems with blurry or double vision. In a case like this, there might be surgical techniques that can help address the situation. A course of steroid treatments may also help.

On average less than 5% of people with thyroid eye disease experience severe symptoms. This includes problems with a disabling level of double vision, corneal ulcers, and optic nerve issues. Left unchecked these problems could gradually lead to a loss of vision.

What Are My Surgical Options?

In cases where surgical intervention is required to address permanent symptoms of thyroid eye disease, your eye doctor or endocrinologist may need to refer you to a specialist. The most common option is called Decompression surgery. This technique is designed to create more space behind the eyes to reduce pressure on the nerve as well as reduce any protrusion of the eyeballs.

There are also other surgical methods which might be needed to address problems with eye muscles or to improve problems with double vision. Eyelid surgery might also be needed to address alterations in the appearance or function of the eyelids.

If you have recently been diagnosed with Grave’s disease or some other type of thyroid problem, you need to also be mindful of early symptoms of thyroid eye disease. If you have started to experience symptoms, it’s best to see a referral or schedule an appointment with an eye doctor. The sooner you seek diagnosis and treatment the less likely you are to experience severe complications.