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Thyroid Eye Disease


THYROID EYE DISEASE (TED)

The same antibodies that attacked the thyroid can also attack the eyes because the same type of cells in the thyroid can also found behind the eyes. It's not uncommon for people who have mild to severe Graves Disease to also have Thyroid Eye Disease (TED) which causes your eyes to bulge out and the eye lids don't close completely which is needed to protect your eyes from bright light and dryness.

SYMPTOMS:

  • Pain/Pressure behind the eyes
  • Feeling of sand in the eyes
  • Irritated and Itchy - similar to pink eye
  • Puffiness around the eyes
  • Headaches or Migraines
  • Sore/extreme tired eyes
  • Sensitive to light
  • Watery eyes (dry eyes)
  • Frequent stringy mucus
  • Waking up with eyes glued shut
  • Double vision
  • Starry-eyed look - like deer in headlights

It's a good idea for anyone who has Graves Disease to see an Ophthalmologist who specializes in Thyroid Eye Disease (TED) to get a base line but if you have symptoms it's a really good idea so the doctor can help manage the symptoms.

Most of the time it takes about a year for TED to go into remission after treating the thyroid and the thyroid levels are within range. Depending upon the severity of hyperthyroidism, it could be over two years.

TED can be very painful at times but it is manageable. If you can't afford to see an Ophthalmologist your Endocrinologist should be able to help you. It's very important to keep your eyes moist - most doctors recommend GenTeal or Sustain liquid eye drops and nighttime ointment.


TREATMENT OPTIONS

Typical Initial Home Treatment:

  • Frequent eye drops to keep the eyes moist.
  • Night-time eye ointment
  • Wear a snug eye mask at night when sleeping.
  • Selenium/Brazilian Nuts for mild TED has shown promise.
  • Blackout curtains for the bedroom to avoid the sun


More advanced Treatment prescribed by an Ophthalmologist:

  • Prednisone / Anti-inflammatory medication
  • Eye Plugs
  • Radiation Therapy
  • IV Corticosteroid therapy
  • IV Rituximab Therapy
  • Orbital Decompression surgery
  • Eyelid Surgery
  • Eye Muscle Surgery
  • Botox Injections - still under review


HELPFUL TIPS FOR MANAGING THYROID EYE DISEASE

  • Use eye drops routinely throughout the day.

  • Night time eye ointment before going to bed.

  • Wear an eye mask at night when sleeping to keep the eyes from drying out.

  • Black out curtains in the bedroom help a huge amount when first waking up. That morning sun can be very painful!

  • At the end of a really bad day try sleeping with swimming goggles at night. Not very comfortable but they create an air tight chamber to prevent the eyes from drying out.

  • If you enjoy reading, Invest in an E-reader so you can adjust the font.

  • Sunglasses are a must. I never leave home without them!

  • Discuss eye plugs with your doctor. They are small little plugs inserted into the inner corner of the eyes to plug the tear ducts to keep the moisture around the eyes.

  • A little tip when taking photos is to have the camera above eye level angled down to avoid the appearance of staring bulging eyes.