Thyroid eye disease (TED) is an autoimmune disease caused by the activation of orbital fibroblasts by autoantibodies directed against thyroid receptors.
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.
The first phase is called the acute phase, or active phase when symptoms are apparent. The second is called the chronic phase, or the inactive phase when there are few or no symptoms. Thyroid Eye Disease begins with the acute phase, when symptoms appear suddenly and usually worsen quickly.
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.
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.
There is growing evidence of thyroid eye disease association with nutritional deficiencies including selenium and vitamin D.
There are two phases. The active phase, marked by inflammation, usually lasts from six months to two years. The focus during this stage is on medical treatment to relieve the eye symptoms. During the second phase, or the stable phase, inflammation and other symptoms have subsided.
TED is a rare disease, which had an incidence rate of approximately 19 in 100,000 people per year in one study. The disorder characterized by enlargement of the extraocular muscles, fatty and connective tissue volume.
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. The inflammation (redness and swelling) and scarring that start to form during this phase can damage your eyes, and cause a number of changes.
One of the first things your doctor or ophthalmologist will look for is the classic symptoms of thyroid eye disease. A few of the symptoms they'll look out for during an eye exam include: Irritation or grittiness. Redness.
Dry, Gritty, or Teary Eyes
The film over your eyes can dry out. It might feel like you've got something in your eye. Irritation can make your eyes tear up a lot, too. That means it's possible for your eyes to be both dry and watery.
Avoid taking your thyroid hormone at the same time as:
Iron supplements or multivitamins containing iron. Calcium supplements. Antacids that contain aluminum, magnesium or calcium. Some ulcer medications, such as sucralfate (Carafate)
TEPEZZA reduces eye bulging and double vision.
Stay away from energy drinks and supplements, limit your intake of caffeinated sodas and chocolate, and try switching to decaf coffee or tea. Iodine ramps up your thyroid's production of thyroid hormone, which is an effect that people with Graves' disease should aim to prevent.
Symptoms of Rash Due to Thyroid Disease
This itchy rash can occur on the neck, chest, back, face, and buttocks.
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).
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.
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 best surgery for Graves' disease is complete expert removal of the entire thyroid gland.
Fluctuating levels of thyroid hormone can often worsen the eye disease. In TED, the immune cells that attack the thyroid gland (to cause Graves' disease) also attack adipose (body fat) and fibroblast tissues around the eyes.
Common signs
An overactive thyroid can also cause the following physical signs: a swelling in your neck caused by an enlarged thyroid gland (goitre) an irregular and/or unusually fast heart rate (palpitations) twitching or trembling.