Thyroid Eye Disease/Graves'

There are many different names you might find for the autoimmune eye condition that is often seen with thyroid disease, including:

·         Thyroid Eye Disease, sometimes abbreviated as TED

·         Graves' Opthamolopathy / Orbitopathy (GO)

·         Thyroid-associated orbitopathy (TAO)

·         Grave's orbitopathy

Thyroid Eye Disease is an a systemic autoimmune disease eye condition that affects the eyes. While it is separate from Although it often occurs with thyroid disease, it is a separate disease process and may be associated with hyperthyroidism or hypothyroidism and even in people with no evidence of thyroid dysfunction and is often seen in conjunction with Graves' Disease. The condition, however, is seen in people with no other evidence of thyroid dysfunction, and occasionally in patients who have Hashimoto's Disease. Most thyroid patients, however, will not develop thyroid eye disease, and if so, only mildly so.

Signs and Symptoms of Thyroid Eye Disease

Signs and symptoms include:

·         Pain Ache and pain with eye movement in the eyes, and pain when looking up, down or sideways

·         Dryness, itching, dry eyes, difficulty wearing contact lenses

·         Redness and swelling of the eye and eyelids, and surrounding tissues

·         Swelling in the orbital tissues which causes the eye to be pushed forward -- referred to as exophthalmos -- which can make Thyroid Eye Disease sufferers appear to have a wide-eyed or bulging stare.

·         Bloodshot appearance to eyes

·         Double vision from inflammation of ocular muscles

·         Impaired vision in severe cases when the eye muscles squeeze the optic nerve  affecting visual acuity, peripheral and color vision.

Thyroid Eye Disease is known to go through varying degrees of severity, and can go into periods of remission as well. When it has been inactive for a period of 18 months, it's less likely to recur. Treatments for Thyroid Eye Disease range from lubricating eye drops and ointments to, in very rare cases, surgery. In a very small percentage of patients, orbital decompression may be called for.

Facts about TED/Graves’

Graves’ disease occurs unless than ¼ of 1% of the U.S, population. About 3,000,000 patients in the U.S. and Europe have the condition and there are 37,000 new cases per year in the U.S.  Up to 80% of patients with Graves’ develop eye symptoms. Graves’ opthalmopathy is more prevalent in Caucasian women between the ages of 30 and 50.

The active phase of TED varies, in some patients symptoms resolve quickly, although, on average the active phase lasts about 12-18 months.

TED occurs in 25-50% of people with Graves’ disease.

Smoking is the most important risk factor for developing TED. Patients who smoke are reported to have a 4-14 fold increase in TED.

Vigilance is needed for any features of possible neuropathy, such as blurred vision, impaired color perception and reduced visual acuity.

Up to 35%of patients require high dose steroids or orbital decompression therapy.  The response rates to steroid therapy range from 33-66%.

TED requires specialist management by an ophthalmologist as well as a thyroidologist.

There is a marked family preponderance, which has lead to speculation that there may be a genetic component