Thyroid Eye Disease (TED), also known as Graves' orbitopathy or thyroid-associated ophthalmopathy, is a serious condition where the immune system mistakenly attacks the tissues surrounding the eyes. This leads to inflammation and can result in a range of symptoms, from mild discomfort to severe issues like vision problems or noticeable changes in the eye appearance.

Key Symptoms of Thyroid Eye Disease (TED)

The symptoms of TED can vary widely, from minor irritation to more severe visual changes. Here are some common signs to be aware of:

Protruding Eyes (Exophthalmos): One of the hallmark symptoms of TED is exophthalmos, where the eyes bulge outward due to inflammation and swelling in the tissues around the eye socket. This often develops gradually and may initially go unnoticed.

Dryness and Irritation: People with TED often experience dry, red, and irritated eyes, which can feel like common dry eye syndrome. However, standard over-the-counter treatments usually offer limited relief.

Eyelid Swelling or Retraction: Swelling or pulling back of the eyelids is a common issue in TED. This can make the eyes look “stiff” and may be mistaken for allergies or conjunctivitis.

Double Vision (Diplopia): TED can cause double vision due to muscle swelling behind the eyes, especially when looking in certain directions. If left untreated, this symptom can worsen over time.

Eye Pressure or Pain: A constant feeling of pressure, discomfort, or pain around the eyes is common, particularly when moving the eyes or straining.

Light Sensitivity (Photophobia): Inflammation from TED can make eyes overly sensitive to light, which is often confused with migraines or other conditions.

Difficulty Moving the Eyes: When the muscles around the eyes become inflamed and stiff, it may be hard to move the eyes in certain directions without discomfort or double vision.

These symptoms can vary in intensity, with some people experiencing them gradually or subtly at first. If any of these signs persist, it’s important to consult an ophthalmologist.

How Common is Thyroid Eye Disease?

While TED might seem rare, it’s actually relatively common among people with thyroid disorders. Studies indicate that about 50% of individuals with thyroid disease also develop TED. For the general U.S. population, the annual incidence is around 16 cases per 100,000 women and 2.9 cases per 100,000 men (Source: National Library of Medicine).

TED tends to occur in two peak age groups: women are most affected between 40-44 and 60-64 years, while men tend to develop TED in the 45-49 and 65-69 age ranges. Older adults may experience more severe symptoms, such as restrictive myopathy and dysthyroid optic neuropathy (DON) (Source: National Library of Medicine).

Environmental Factors: Smoking has been strongly linked to TED, as it is believed to exacerbate symptoms and increase the likelihood of developing the condition. Quitting smoking and addressing other environmental factors can help reduce the risk of TED and improve outcomes.

Treatment Options for TED

Treatment for TED varies depending on symptom severity. One of the most effective treatments is Tepezza (teprotumumab), a medication specifically designed for TED. Tepezza targets the proteins responsible for eye inflammation and tissue swelling, reducing symptoms such as bulging eyes and double vision, and significantly improving both appearance and vision (Source: Tepezza).

For milder cases, lubricating eye drops or sunglasses can help relieve dryness and light sensitivity. In more severe cases, surgical options, like orbital decompression, may be required to preserve vision (Source: Thyroid Eyes).

Final Thoughts

Recognizing the signs of TED early can lead to prompt treatment and prevent the condition from worsening. Being aware of the prevalence and risk factors associated with TED helps individuals seek specialized care when necessary. If you or someone you know is experiencing persistent eye symptoms or has a history of thyroid disease, it’s crucial to consult an ophthalmologist for a thorough evaluation.