10 Signs of Thyroid Eye Disease (and How to Help it)

Here’s how doctors diagnose and treat TED (thyroid eye disease).

Thyroid Eye Disease (TED) can be a challenging condition that affects vision and quality of life. Understanding the signs and symptoms of TED is crucial for early detection and effective management. 

This article will tell you about the key signs of TED and offer practical advice on managing this condition.

What is Thyroid Eye Disease?

Thyroid Eye Disease (TED) is an autoimmune disorder. The disease affects the muscles and tissues around your eyes. It’s most commonly associated with Graves’ disease, a type of hyperthyroidism. However, it can also occur in people with normal thyroid function or even hypothyroidism. 

TED occurs when the immune system mistakenly targets the tissues around the eyes, causing inflammation and other symptoms. 

What Are the Key Risk Factors for Thyroid Eye Disease?

• Smoking. Smoking is among the most prominent risk factors for developing TED. It can worsen symptoms and lead to a more severe progression of the disease. Quitting smoking is strongly recommended to help manage TED effectively.
• Having a family history of thyroid disorders. If your family members have thyroid issues, you are at a higher risk of developing TED. Genetic predisposition plays a crucial role, and it’s essential to monitor your thyroid health regularly if you have a family history of thyroid disorders.
• Being female makes it more likely that someone will develop this condition. Women are more prone to developing TED than men. Hormonal differences and autoimmune responses may contribute to this increased risk. Women should be particularly vigilant about early signs and symptoms of TED.

Ten Key Signs of Thyroid Eye Disease

According to the American Thyroid Association, these are the key signs someone is developing TED:

Sign 1: Bulging Eyes (Exophthalmos)

One of the most noticeable signs of TED is bulging eyes or exophthalmos. This condition occurs because the tissues and muscles behind your eyes become swollen and push your eyes forward. This can make your eyes look more prominent and can affect how you close your eyelids. Exophthalmos can also lead to symptoms like dryness and irritation because your eyes might not close completely, exposing them.

Sign 2: Gritty Sensation in the Eyes

Many people with TED experience a gritty sensation, similar to having sand in their eyes. This feeling is due to inflammation and swelling in the tissue around the eyes, which can affect tear production and lead to dryness. The gritty sensation can be very uncomfortable and make it hard to focus on tasks.

Sign 3: Pressure or Pain in the Eyes

Pressure or pain in the eyes is another common symptom of TED. This can be a dull, constant ache or sharp, intermittent pain. The pressure comes from the swelling of the tissues and muscles around the eyes, which can also affect your vision. If you experience significant pain or pressure, it’s essential to seek medical advice, as these symptoms can indicate worsening of the condition.

Sign 4: Puffy or Retracted Eyelids

TED can cause your eyelids to become puffy or retract. Puffy eyelids occur because of fluid retention and inflammation, making your eyes look swollen. Retracted eyelids, on the other hand, are when the upper eyelid is pulled back, exposing more of your eye. Both conditions can make your eyes more vulnerable to dryness and irritation.

Sign 5: Reddened or Inflamed Eyes

Reddened or inflamed eyes are also typical symptoms of TED. The inflammation can make your eyes’ whites appear red and cause discomfort. This redness is due to the increased blood flow and swelling in the tissues around the eyes. The inflammation can worsen if left untreated, leading to more severe symptoms and complications.

Sign 6: Light Sensitivity and Thyroid Eye Disease

Many people with TED become sensitive to light, a condition known as photophobia. This happens because the swollen tissues around your eyes can affect how your eyes react to light. Light sensitivity can make it hard to be outside on sunny days or in brightly lit rooms. Wearing sunglasses and using dim lighting indoors can help manage this symptom.

Sign 7: Double Vision (Diplopia)

Double vision, or diplopia, occurs when swelling affects the muscles around the eyes. The swollen tissue causes the eyes to become misaligned. This misalignment can make it difficult for the eyes to focus on the same point, leading to double vision. Diplopia can significantly impact daily activities, making reading and driving challenging.

Sign 8: Vision Loss

In severe cases, TED can lead to vision loss. This decreased eyesight occurs when the inflammation and swelling compress the optic nerve, which is crucial for vision. Early detection and treatment are paramount to preventing permanent damage to your vision. If you observe any changes in your eyesight, see a healthcare professional.

Sign 9: Dry Eyes

Dry eyes are a common symptom of TED, resulting from the inability to close the eyelids fully or decreased tear production due to inflammation. When your eyes don’t produce enough tears or when tears evaporate too quickly, your eyes can become dry and uncomfortable. This dryness can lead to a gritty sensation, redness, and a feeling of having something in your eye.

Sign 10: Excessive Tearing

Excessive tearing may seem counterintuitive if you also experience dry eyes, but it’s a common symptom of TED. When irritated or dry, your eyes may produce more tears in response. However, these tears often do not lubricate the eyes effectively, leading to a cycle of dryness and excessive tearing. This can be very uncomfortable. Moreover, it can affect your daily life.

How to Help Manage Thyroid Eye Disease

Managing TED effectively requires a combination of medical treatments and self-care strategies. Working closely with your healthcare professional to monitor your eyes’ condition and adjust your treatment plan whenever needed is essential. Here are some general eye health tips to help manage TED:

• Medical Treatments: Depending on the nature of your symptoms, your doctor may recommend medications to reduce inflammation, such as corticosteroids or immunosuppressive drugs.
• Regular Check-Ups: Regular visits to a qualified specialist are crucial for monitoring the progression of TED and adjusting your treatment plan. These check-ups can help you detect any changes in your condition early and allow for prompt intervention.
• Lifestyle Changes: Making specific lifestyle changes can help alleviate TED symptoms. Quitting smoking is one of the most critical steps you can take, as smoking can worsen TED. Protecting your eyes from wind and bright light, using lubricating eye drops, and keeping your head elevated while sleeping can help reduce symptoms.

Self-Care Tips for Thyroid Eye Disease

In addition to those medical treatments, self-care strategies can help manage TED symptoms and improve your quality of life:

• Eye Protection: Wearing sunglasses outdoors can protect your eyes against bright light and wind, worsening symptoms. If your eyes don’t close completely, using an eye mask while sleeping can help keep your eyes moist.
• Lubricating Eye Drops: Over-the-counter lubricating eye drops or gels can help alleviate dryness and irritation. Regular use can keep your eyes comfortable and reduce the gritty sensation.
• Healthy Diet: Enjoying a balanced diet rich in vitamins and minerals can support your general health and help manage TED. Foods high in antioxidants, including fruits and vegetables, can reduce inflammation and support eye health.
• Exercise and Relaxation: Regular exercise can improve your overall well-being and reduce stress, which can worsen TED symptoms. Relaxation techniques, which often include meditation or deep breathing exercises, can also help manage your stress levels and promote a positive outlook.

Additional Medical Treatments for Thyroid Eye Disease (if Previous Efforts Have Not Worked)

If you have tried but those self-care tips don’t help, your doctor will likely suggest additional measures to relieve the discomfort. These medical treatments can help you manage the symptoms of TED:

• Medications: Corticosteroids like prednisone can reduce inflammation and swelling around the eyes. Other medications, such as teprotumumab, can target specific pathways involved in the inflammation process. Immunosuppressive drugs may also be used to control the immune response that causes TED.
• Surgery: According to the Mayo Clinic, surgical options may be necessary to correct thyroid eye disease. Orbital decompression surgery involves removing bone from the eye socket, thus creating more space for the swollen tissues and relieving pressure on the optic nerve. Eyelid surgery can also correct the position of the eyelids to improve their function and appearance. Eye muscle surgery can help align the eyes and reduce double vision.

Final Thoughts on a Thyroid Eye Disease Diagnosis

Recognizing the signs and symptoms of Thyroid Eye Disease is critical for early detection and effective management. If you experience any symptoms described in this article, it’s important to seek medical advice promptly. With the right combination of medical treatments and self-care strategies, you can manage TED effectively and maintain a good quality of life. Stay informed, work closely with your healthcare professional, and take proactive steps to care for your eyes and overall health.