Understanding Thyroid Eye Disease

hyroid Eye Disease (TED), sometimes referred to as Graves' Ophthalmopathy (in conjunction with hyperthyroidism), Dysthyroid Eye Disease, or Thyroid-Associated Orbitopathy, is a lesser-known condition resulting from an imbalance in thyroid hormones. This imbalance can manifest as either hyperthyroidism, characterised by excessive thyroid hormone production, or hypothyroidism, marked by insufficient thyroid hormone production. TED is an autoimmune disorder affecting the eyes and the surrounding tissues within the orbit. This ailment leads to both functional impairments and cosmetic changes, potentially causing a significant psychosocial impact due to altered appearance and, if left untreated, potential vision deterioration.

The symptoms of TED arise progressively as a consequence of an autoimmune response targeting various parts of the eye and orbital tissues, leading to inflammation and swelling. These symptoms include:

1. A fixed or startled gaze due to the tightening of eyelid muscles.
2. Swelling around the eyes, particularly pronounced upon waking (puffy appearance).
3. Eye bulging attributed to the involvement of eye muscles and orbital fat.
4. Double vision arising from the enlargement and swelling of eye muscles.
5. Instances of redness, pain, and watering of the eyes.
6. Dry eyes stemming from the swelling within the tear gland.
7. Diminished vision due to pressure exerted on the optic nerve.

Around 25% of individuals experience TED symptoms prior to the diagnosis of their thyroid disorder. The severity of eye symptoms can vary, ranging from mild to severe, with asymmetrical involvement of one eye more than the other.

Diagnosis of TED involves a simple eye examination conducted by an ophthalmologist, especially those with expertise in oculoplastic/eye plastic surgery. Collaboration with endocrinologists is often required due to the underlying thyroid condition. Confirmatory blood tests may be necessary, and imaging such as CT scans or MRIs of the orbit might be performed to assess the extent of TED. Treatment strategies for TED are tailored to the disease's severity, primarily addressing the inflammatory and damaging effects of the condition. Depending on the level of severity:

1. Mild TED may be managed with artificial tear drops/gels to alleviate symptoms.
2. Moderate cases may necessitate steroid or immunosuppressive therapies.
3. Severe instances might require decompression surgery to prevent vision loss.

The risk factors for developing TED predominantly revolve around thyroid imbalance. Roughly 80% of TED cases are linked to hyperthyroidism, while 10-15% are associated with hypothyroidism or normal thyroid function (euthyroidism). TED is more commonly observed in middle-aged individuals, and those with a family history of thyroid issues face an elevated risk of developing this condition.

It's advisable to seek an eye examination if you experience:

• Thyroid imbalance
• Staring or bulging of eyes
• Double vision
• Persistent redness or eye pain
• Vision deterioration
• Difficulty in closing the eyes

In summary, Thyroid Eye Disease, also known by various synonymous terms, arises from thyroid hormone imbalances and manifests as an autoimmune-driven condition affecting the eyes and orbital tissues. Its symptoms can range from mild to severe, potentially impacting both appearance and vision. Early diagnosis and collaborative treatment approaches involving ophthalmologists and endocrinologists are crucial for effective management.?

If you're seeking expert advice regarding Thyroid Eye Disease, Dr.?Savari Desai, Consultant –?Ophthalmologist, Oculoplasty, Orbit, Ocular Oncology and Facial Aesthetic Surgeon,? P. D. Hinduja Hospital & Medical Research Centre in Mahim, Mumbai.?

To book an appointment, please contact the hospital at the following phone numbers: 022 6766 8181 or 022 4510 8181.?

*Information source: Bombay Times