Thyroid eye disease (TED)

Thyroid eye disease (TED), also known as Graves' ophthalmopathy or thyroid-associated ophthalmopathy, is an autoimmune condition that occurs as a result of an overactive thyroid gland (hyperthyroidism). In TED, the body's immune system mistakenly attacks the tissues of the thyroid gland and the tissues around the eyes, specifically the eye sockets and eye muscles.

Cause of Thyroid eye disease (TED)

The exact cause of TED is not fully understood, but it is believed to be related to an autoimmune reaction. In individuals with hyperthyroidism, the immune system produces antibodies that mistakenly target and attack healthy tissues, including those in the thyroid and the tissues surrounding the eyes.

Symptoms

TED can cause a variety of eye-related symptoms and signs, including:

  1. Swollen and congested tissues: Inflammation of the tissues in the eye socket leads to swelling and congestion, resulting in swollen and red eyelids.

  2. Proptosis (bulging eyes): The inflammation behind the eye can push the eyes forward, causing them to bulge or protrude from the eye sockets.

  3. Eyelid retraction: The inflammation can also lead to retraction of the eyelids, causing them to open wider than usual (lid retraction).

  4. Sore and red eyes: The inability of the eyelids to fully close can result in dryness and irritation of the eyes, leading to soreness and redness.

  5. Eye muscle involvement: Swelling of the eye muscles can impair their ability to contract and relax properly, affecting eye movements and causing double vision or difficulty in moving the eyes.

Treatment

The management of TED involves a multidisciplinary approach and may include the following:

  1. Treating the underlying thyroid disorder: If hyperthyroidism is present, it is essential to manage and control the overactive thyroid gland through medication, radioactive iodine therapy, or surgery.

  2. Symptomatic relief: Artificial tears and lubricating eye drops can provide relief from dry eyes. Elevating the head while sleeping and using humidifiers can also help alleviate symptoms.

  3. Steroids: Oral or intravenous steroids may be prescribed to reduce inflammation in severe cases of TED.

  4. Immunosuppressive therapy: Immunosuppressive medications may be used to suppress the immune system's activity and reduce inflammation.

  5. Surgery: In some cases, surgical intervention may be necessary to correct severe eye problems, such as proptosis or double vision.

The treatment plan for TED is tailored to each individual's specific symptoms, severity of the disease, and response to therapy. It is important to work closely with an endocrinologist and an ophthalmologist experienced in managing TED to ensure the best possible outcome.