Thyroid Eye Disease (TED), also called Graves' orbitopathy or thyroid-associated ophthalmopathy, is a serious condition in which the immune system mistakenly targets the tissues around the eyes. This leads to inflammation and a range of symptoms, from mild discomfort to more severe complications, including visual impairment or changes in the appearance of the eyes.

Common Signs and Symptoms of Thyroid Eye Disease (TED)

TED symptoms vary, ranging from mild irritation to more severe vision changes. Here are some key symptoms to watch for:

Bulging Eyes (Exophthalmos): A primary symptom of TED, exophthalmos occurs when the eyes protrude outward due to inflammation and swelling in the tissues surrounding the eye socket. This often develops gradually and may initially go unnoticed.

Dryness and Irritation: Many people with TED experience dryness, redness, and discomfort similar to common dry eye syndrome. However, typical over-the-counter treatments often provide limited relief.

Eyelid Swelling or Retraction: Swelling or retraction of the eyelids is a common feature of TED. This can make the eyes appear “stiff” and may be mistaken for allergies or conjunctivitis.

Double Vision (Diplopia): Swelling of the muscles behind the eyes can cause double vision, particularly when looking in certain directions. If left untreated, TED-related double vision may worsen over time.

Eye Pressure or Pain: Many people with TED experience a constant sensation of pressure, discomfort, or even pain around the eyes, especially when moving the eyes or straining.

Light Sensitivity (Photophobia): Inflammation caused by TED can increase sensitivity to light, which is often mistaken for a migraine or other conditions.

Difficulty Moving the Eyes: Inflammation in the eye muscles can make it hard to move the eyes in certain directions without pain or double vision. This reduced mobility is known as restrictive myopathy.

These symptoms can vary in intensity and may develop gradually, so the progression of TED can differ from person to person. If you experience persistent symptoms, it’s essential to see an ophthalmologist for a proper evaluation.

TED is More Common Than You Think

Although TED may seem like a rare condition, it’s actually relatively common in people with thyroid disease. Studies show that about 50% of people with thyroid disorders develop TED. For the general U.S. population, the 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: 40-44 and 60-64 years for women, and 45-49 and 65-69 years for men. Older individuals are more likely to experience severe forms of the disease, such as restrictive myopathy and dysthyroid optic neuropathy (DON) (Source: National Library of Medicine).

Environmental Factors: Smoking is strongly linked to TED, as it can worsen symptoms and increase the likelihood of developing the disease. Quitting smoking and managing other environmental factors can help reduce the risk and improve the condition's outcome.

Treatment Options for TED

Treatment for TED depends on the severity of the symptoms. One of the most effective treatments is Tepezza (teprotumumab), a drug specifically developed for TED. Tepezza works by targeting the proteins that cause inflammation and swelling in the eyes, helping to reduce symptoms like bulging eyes and double vision. It has a significant impact on improving both the appearance and vision (Source: Tepezza).

For milder cases, lubricating eye drops or wearing sunglasses may help relieve dryness and light sensitivity. In more severe cases, surgical procedures, such as orbital decompression, may be necessary to protect vision (Source: Thyroid Eyes).

Final Thoughts

Recognizing TED symptoms early can allow for prompt intervention and potentially slow or stop the disease's progression. Understanding the prevalence and risk factors for TED has helped many people seek specialized treatment before the condition becomes severe. 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.