Some patients are left with permanent changes, and in others the eyes return to normal. A great deal can be done to improve these conditions with medical treatment, although some patients will need surgery to help ease their issues.
Some individuals with mild thyroid eye disease may be treated with supportive measures such as dark sunglasses to treat sensitivity to light, ointments, artificial tears, and/or prisms that are attached to glasses. Prisms can help correct double vision. Some people may wear an eyepatch to manage double vision.
Management and Treatment
Graves' disease is a lifelong (chronic) condition. However, treatments can keep your thyroid hormone levels in check. Medical care may even make the disease temporarily go away (remission).
Living with TED can be both physically and emotionally challenging for people as their everyday lives are affected, from being unable to drive with double vision or sleeping with their eyes open. Some patients are unable to work due to visual changes or pain behind the eye.
A series of surgeries can correct the bulging appearance of your eyes, minimize double vision, bring the eyelids into the correct position, and address the sometimes jarring physical changes that come with the disease. These surgeries are “staged” or performed in a specific order.
Total thyroidectomy prevents further progression of Graves' eye disease and is an immediate cure of the process. For this reason, surgery is the preferred treatment for patients with Graves' eye disease.
The outlook is good for most people with thyroid eye disease. Mild thyroid eye disease may resolve on its own, while more serious cases of TED may require a combination of therapies. The outlook for people who are over 50 years old when diagnosed may not be as positive.
Radioactive iodine can worsen TED and is generally not recommended in individuals with moderate-to-severe or sight-threatening eye disease. In individuals with mild eye disease, radioactive iodine can be considered as initial treatment.
TED is an autoimmune disease, meaning that the inflammation and scarring are caused by an attack from the body's immune system. TED is primarily associated with an over-active thyroid gland due to Graves' disease, although it can rarely occur in patients with an under-active or normally functioning thyroid gland.
Some patients are left with permanent changes, and in others the eyes return to normal. A great deal can be done to improve these conditions with medical treatment, although some patients will need surgery to help ease their issues.
Thyroid eye disease (TED) is an autoimmune disease caused by the activation of orbital fibroblasts by autoantibodies directed against thyroid receptors. TED is a rare disease, which had an incidence rate of approximately 19 in 100,000 people per year in one study.
Thyroid Eye Disease (TED) is a serious, potentially vision-threatening condition that can get worse over time, but can be managed with treatment. When you have TED, your immune system mistakenly attacks the muscle and fat tissue behind your eyes, causing inflammation (redness and swelling) and scar tissue to form.
TED has 2 phases, and can be treated in both. The first is called the “acute” phase, which you may also hear your doctor call the “active” phase of TED. The second is called the “chronic” phase, which your doctor may call the “inactive” phase. This does not mean TED has gone away.
Elevate Your Head in Bed
Swollen eyelids are a common symptom of thyroid eye disease. Instead of lying flat as you sleep, raise the head of your bed.
If so, they are likely asking themselves, “is Graves' disease considered a disability?” The answer is yes. When severe enough, Graves' disease is considered a disability.
Early symptoms of thyroid eye disease are itching, watering or dry eyes and a feeling of grittiness of the eyes. Some people may notice a swelling around the eyelids and sometimes the front of the eye becomes swollen.
FACT: You can develop TED without having Graves' disease.
While it's true that many people are diagnosed with Graves' before being diagnosed with Thyroid Eye Disease (TED), it's not always the case. In fact, about 1 in 10 people with TED develop it without having Graves' disease.
A diet high in calcium may help. Foods that contain calcium include some dairy products, but caution needs to be taken as to which of those do not contain iodine as well. Other foods high in calcium include broccoli, almonds, kale, sardines, and okra. Foods high in vitamin D, magnesium and selenium are also beneficial.
"In the long term, the eyes may improve or remain a problem -- with obvious bulging, double vision, and cosmetic problems from edema around the eyes. Once the disease inflammation settles, then any corrective surgery can be planned," he said.
Thyroid eye disease, also known as Graves' ophthalmopathy, affects an estimated 1 in every 6,250 women and 1 in 34,482 men, according to the National Organization for Rare Disorders (NORD).
These are some other celebrities with Graves' disease: Former President George H.W. Bush and his wife Barbara Bush were diagnosed with Graves' disease while he was in office. Olympic medalist Gail Devers almost had to abandon her athletic career due to Graves' disease.
If you have Graves' disease, eye symptoms most often begin within six months of disease diagnosis. Very rarely, eye problems may develop long after the Graves' disease has been treated. In some patients with eye symptoms, hyperthyroidism never develops and, rarely, patients may have hypothyroidism.
Because TAO can precede, coincide with or succeed the diagnosis of thyroid dysfunction, optometrists need to be capable of making an early diagnosis, as TAO can be vision-threatening, impact a patient's appearance and result in loss of quality of life.