The most common sign of TED is upper eyelid retraction, unilateral or bilateral, that occurs in over 90% of patients12,13 (Figure 1). The resultant wide-eyed appearance allows for chronic eye exposure, especially during sleep. Foreign body sensation, dryness, and tearing occur initially.
The patient complains of gritty sensations, photophobia, lacrimation, dry eye, discomfort, and forward protrusion of the eye. In more advanced cases, patient may complain eye socket (orbital) pain, double vision, or blurred vision.
Signs and Symptoms of Graves' Eye Disease
In Graves' eye disease the tissue around the eye is attacked, and the result is inflammation and swelling, causing: Redness and pain. Puffiness around the eyes. Bulging of the eyes.
To diagnose thyroid eye disease, you will need a complete eye exam, lab tests, and imaging tests. The ophthalmologist will test your vision, color vision, and visual fields. In addition, eyelid measurements will be taken, eye pressure tested, and optic nerve checked.
Although severe thyroid eye disease is rare (affecting only one in twenty of all TED patients),6 it carries a major risk of sight loss due to corneal exposure, orbital congestion and optic neuropathy, and such patients should therefore be treated urgently to avoid irreversible loss of vision.
The first step is to make an appointment with your doctor, who will likely refer you to an ophthalmologist. They will perform some tests to see if you have thyroid eye disease, also known as Graves' eye disease or Graves' orbitopathy.
About 90% of patients with TED have hyperthyroidism. Hyperthyroidism and TED are due to the same underlying autoimmune process. In the active phase of TED, fluctuations in the levels of thyroid hormone (both underactive as well as overactive) can lead to progression of TED.
Symptoms of Rash Due to Thyroid Disease
This itchy rash can occur on the neck, chest, back, face, and buttocks.
Eye problems will usually occur and frequently change in type or severity for between six months and two years. Once stabilized, it is unusual for the eyes to start changing again. Some patients are left with permanent changes, and in others the eyes return to normal.
When Is Thyroid Eye Disease an Emergency? Thyroid eye disease (also called Graves' orbitopathy) becomes an emergency when it is threatening your eyesight. Vision loss from thyroid eye disease may be irreversible. Usually, treatment can help keep symptoms from progressing or becoming severe.
One of the biggest risks of untreated thyroid eye disease is vision loss. The most common vision problems with Graves' orbitopathy include blurriness and double vision. Colors may also appear somewhat dull.
TED begins with an acute phase, which means that symptoms appear suddenly and often get worse. The acute phase can last from 6 months to 2 years.
Graves' eye disease usually affects both eyes, but you may only notice symptoms in 1 eye. Symptoms usually last 1 to 2 years and often go away on their own. In rare cases, swelling around the eyes can press on the optic nerve (the nerve that connects the eye to the brain) and cause vision loss.
Coping with vision problems
People with TED should not drive if their vision blurs or they experience double vision. People with TED may be legally required to let their state motor vehicle department and insurance company know about a diagnosis that could impair their driving.
People need to know that thyroid eye disease can occur “at any time, in anyone, whether they have thyroid disease or not,” she says. “A healthy lifestyle that emphasizes the need to reduce stress and avoidance of smoking are always the most important steps to take regardless.”
As thyroidectomy removes all or nearly all thyroid tissue from the neck, this will result in a more rapid decrease in antibody production over time, which is beneficial for those with eye disease.
It causes dry, gritty eyes, blurred or double vision, and pain when moving the eyes up and down or from side to side. It may also cause bulging or protruding eyes. The disease is temporary, going through an initial active period that lasts between six months and two years. During this time, the symptoms may get worse.
Selenium is a nutrient that's important for normal thyroid hormone production. When people with mild thyroid eye disease took 100 micrograms of selenium twice a day for 6 months, the disease didn't progress as quickly as it did for those who took a placebo, according to research.
With Graves' disease, the immune system attacks the thyroid. In TED, the immune system attacks the muscle and fat tissue behind the eyes. Autoimmune diseases are chronic, or lifelong, conditions. The fact that people with Graves' disease often develop TED also causes confusion.
You may feel nervous, moody, weak, or tired. Your hands may shake, your heart may beat fast, or you may have problems breathing. You may be sweaty or have warm, red, itchy skin. You may have more bowel movements than usual.
Jameson. “As the nodules get larger, they can irritate your throat and lead to a long-lasting cough. For most people, this cough is a dry, hacking sort of cough.” In addition to cough, thyroid growth can lead to pressing on the vocal cords and a hoarse voice, or pressing on the esophagus and difficulty swallowing food.
People are often unaware that the thyroid affects our feet as well. Here are some common conditions prevalent in the case of thyroid disorders: Cold lower extremities: When the thyroid is underactive, your body temperature also drops, resulting in cold feet and hands.