What is Thyroid Eye Disease?
Thyroid Eye Disease (TED) is one of the more common causes of orbital disease. Thyroid eye disease can co-exist with both hyperthyroidism (Graves’ Disease) and hypothyroidism. These conditions can cause changes in one’s appearance, such as eyelid changes (eyelid retraction) and proptosis (a protrusion of one or both eyes). These changes may result in other conditions including dry eye syndrome due to the inability of the eyelids to close completely. Double vision may result from enlarged and/or scarred muscles that move the eye. In extreme cases, loss of vision may result from pressure on the optic nerve that connects the eye to the brain.
It is important that the thyroid levels be maintained in normal range. Frequent blood work is necessary to track the levels. Thyroid medication may also help to normalize thyroid levels. Smokers are more prone to develop Thyroid Eye Disease than nonsmokers. It is highly advised to stop smoking and also to avoid second hand smoke.
How is Thyroid Eye Disease Treated?
Apply cool compresses to your eyes. The cold can be soothing to an inflamed, irritated eye.
Wear sunglasses. Light sensitivity is common with Thyroid Eye Disease. Sunglasses can protect the eyes from the sun and wind.
Use lubricating eye drops. Artificial tears can help to relieve dryness and soothe the surface of the eyes. Do not use eye drops that contain redness removers, such as Visine. A lubricating gel can also be used at bedtime to instill thicker lubrication overnight.
Prisms in prescription glasses. If double vision is present, an optometrist can put prisms into the lenses.
Steroids. If the eyes because very swollen and irritated, your doctor may recommend oral steroids to reduce the inflammation.
Eyelid Surgery. In some cases, the eyelids may not close all the way, leaving the eyeballs exposed. The exposure can cause redness, irritation and tearing. Surgery may be helpful to reposition the eyelids.
Eye Muscle Surgery. If prisms were not successful, surgical correction of the eye muscles may be necessary to address the double vision. Thyroid Eye Disease can also cause scarring of the muscle and misalignments. This surgery is referred to as Strabismus surgery and is performed by an Ophthalmologist.
Orbital Decompression Surgery. When the tissues and muscles surrounding the eye becomes so inflamed, it may be necessary to perform an orbital decompression. A bone between the eye socket (orbit) and sinuses is removed to allow for more space of the swollen tissues.
IV Steroids: Steroids given as intravenous infusions can be a great way to reduce the more severe symptoms of thyroid eye disease. This form of treatment is not disease-modifying; however, it improves the soft-tissue symptoms in the active phase until the body can pass into the stable phase.
Radiation: Orbital radiation may be an option to consider for patients who have moderate to severe persistent inflammation. It is given in an outpatient setting and often involves up to 12 visits. An individualized plan will be made between Dr. Lane and an Oncologist.
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