Thyroid Eye disease, causes and treatment

What is thyroid eye disease? (TED)

It is a type of autoimmune, inflammatory condition; however the exact factors linking thyroid disease and TED remain unspecified. TED usually affects both eyes with women being affected more often than men.

What are the symptoms of TED?

Most patients with TED, experience only mild symptoms, such as dryness or eye irritation. Those with significant inflammatory changes may experience the following symptoms:

  • Watery, red eyes
  • Swollen upper or lower eyelids
  • Exophthalmos
  • Double vision
  • Painful eye movements
  • Blurring or loss of vision


Mild disease

In the great majority of patients TED follows a mild course, and artificial tears and / or anti-inflammatory drops may suffice to control symptoms. Oral Selenium supplements are considered most beneficial in mild forms of the disease.

Significant ‘active’ disease 

Current treatments for active orbital inflammation include oral or intravenous steroids (or other immunosuppressive medicines such as Azothioprine) and low dose orbital radiotherapy, aiming to reduce the need for systematic immunosuppressive treatment.

Severe TED 

For such patients, urgent surgical intervention (within days or weeks) may be necessary to protect eyesight. This operation is called ‘orbital decompression’, because it relieves the inflammatory pressure around the eye and the optic nerve behind it.

Permanent damages in TED 

Other surgery, including operations to treat bulging eyes (proptosis), double vision, and abnormal eyelid height or breadth, are usually performed once the condition has receded. Since orbital decompression surgery (to cure stable proptosis) can affect both double vision and the appearance of the eyelids, this surgery, when required, should be performed before any eye muscle surgery or blepharoplasty.