Thyroid Eye Disease

What is thyroid eye disease (TED)?

Thyroid Eye Disease (TED) is an autoimmune condition where the body’s own immune system causes inflammation of tissues of the eye socket. Symptoms can include swollen and red eyelids, bulging/protruding eyes and eyelids open too far (lid retraction). If the eye muscles get very swollen, they can compress the optic nerve at the back of the eye socket causing vision loss.

Although most people with Thyroid Eye Disease have a history of an over- or an underactive thyroid gland, this is not always the case and some people with characteristic eye disease will develop the thyroid problems later and a few will never develop abnormal thyroid function blood tests.

How can I help prevent or improve thyroid eye disease (TED)?

There are four factors known to affect the outcome for Thyroid Eye Disease: Age, Sex, smoking, and thyroid gland activity. Two factors which can be modified, are the thyroid gland activity (needs regular checking by blood tests) and smoking. Smoking seriously worsens the outcome for Thyroid Eye Disease and increases the risk of visual loss from the disease. Please see your GP if you need help with stopping smoking.

What is the treatment for thyroid eye disease (TED)?

• Mild thyroid eye disease (TED):

This may require no treatment, or just some lubricant eye drops to reduce discomfort of the eyes.

• Moderate / Severe thyroid eye disease (TED):

Severe inflammation need to be treated, as it can otherwise lead to problems both during the inflamed phase and with scarring of tissues as the inflammation settles.

The inflammation can be reduced by the use of powerful immune system suppressing drugs, such as steroids, or by radiotherapy. Radiotherapy is similar to that used for treatment of tumours but, with TED, is used at a much lower dosage and so side effects are rare.

• Vision threatening thyroid eye disease (TED):

Eyesight is impaired due to pressure on the optic nerve.  It may be necessary to perform urgent orbital decompression to prevent permanent loss of vision.

• Inactive thyroid eye disease (TED):

This is where the inflammation has settled down, but tight, enlarged eye muscles and orbital tissue remains. This may require squint surgery (surgery on the eye muscles) to improve the double vision and eyelid surgery to improve the appearance or eyelid closure.

Orbital decompression surgery may also be used at this stage to reduce the proptosis to improve the facial cosmetic appearance or reduce the “pressure” behind the eyes.