Thyroid eye disease can occur in up to 25-30% of patients with thyroid disease of which around 3-5% are severe. It is an auto immune condition in which the eye muscles, eyelids, tear glands and fatty tissues behind the eyes can become inflamed and swollen due to the body’s immune cells attacking these tissues.  Due to the limited space in the orbit, this results in the feeling of tightness within the eye socket which pushes the eyeball forward (bulging eyes) and in severe cases, it can compress the optic nerve behind the eye.

Symptoms

• Gritty feeling due to dry eyes
• Congested, red and swollen conjunctiva
• Feeling of tightness
• Dull aching pain behind the eye
• Sensitivity to bright lights
• Eyelid retraction (eyelids cannot close completely)
• Bulging eye (proptosis)
• Puffy eyelids with eye bags
• Double vision due to limitation of eye movements
• Rarely loss of vision when the optic nerve is compressed

Click to view Osmosis video on Thyroid Eye Disease

Risk factors

• Smokers
• Family history
• Poor control of thyroid disease
• Long duration of thyroid disease
• Co-existing auto-immune disorders

Treatment

Prevention

• Adopt a healthier lifestyle with regular exercise
• Quit smoking
• Eat more healthy diet (and avoid too much fried oily foods)
• Get better sleep

Medication

• Apply lubricant eye medication (drops and ointment) to help with the dry eye symptoms
• Glaucoma medication () may be required if the swelling causes your eye pressure to increase
• Keep good control of your thyroid condition (and avoid fluctuations of your hormone levels)
• Steroids and anti-inflammatory medication may be required to treat any active inflammation in the orbit (known as flare-ups or active phases)

Surgery

1. Orbital Decompression may be required in the following circumstances

• Cosmetically unacceptable appearance
• Limited eye movement causing double vision
• Optic nerve compression causing loss of vision

Click to view Moorfieldo Eye Hospital video on Thyroid Eye Decompression

2. Eyelid Surgery may be required to reduce eyelid retraction and avoid corneal exposure.  Persistent corneal exposure can result in recurrent corneal abrasion causing ocular discomfort and pain.

Click to view Moorfieldo Eye Hospital video on Eyelid Surgery in Thyroid Eye Disease

It is important to undergo an Eye Examination by your eye doctor regularly (between every 4-6 months) while you are on treatment for thyroid disorder

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