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Thyroid eye disease, also known as Graves’ ophthalmopathy or Graves’ orbitopathy, is an autoimmune disorder that affects the tissues around the eyes. It is most commonly associated with Graves’ disease, an autoimmune disorder that affects the thyroid gland, but it can also occur in people with other thyroid disorders or no thyroid dysfunction at all.
There are two main phases of thyroid eye disease:
Active Thyroid Eye Disease: This is the early phase of the disease, during which the immune system is actively attacking the tissues around the eyes, leading to inflammation, swelling, and other symptoms.
Active thyroid eye disease may last for several months to a few years and can be very disruptive to a person’s daily life. During this phase, treatment is aimed at reducing inflammation and other symptoms to prevent further damage to the eyes.
Inactive Thyroid Eye Disease: This is the later phase of the disease, during which the inflammation and swelling have subsided and the tissues around the eyes have stabilized.
However, the effects of the disease may be permanent, including changes in the appearance of the eyes, double vision, or other vision problems. In some cases, people with inactive thyroid eye disease may still require ongoing treatment to manage symptoms or prevent further complications.
The symptoms of thyroid eye disease can vary widely among individuals, but may include:
It’s important to note that not everyone with thyroid eye disease will experience all of these symptoms, and the severity of symptoms can vary widely among individuals.
However, in severe cases, thyroid eye disease can lead to vision loss or other complications, such as corneal ulcers, optic neuropathy, or compression of the optic nerve.
Thyroid eye disease is most commonly associated with Graves’ disease, an autoimmune disorder that affects the thyroid gland. As a result, the primary risk factor for thyroid eye disease is having Graves’ disease or another autoimmune thyroid disorder. However, not all people with Graves’ disease or other thyroid disorders will develop thyroid eye disease, and the severity of symptoms can vary widely among individuals.
Other risk factors for thyroid eye disease may include:
Gender: Women are more likely than men to develop thyroid eye disease.
Age: Thyroid eye disease is most common in people between the ages of 30 and 50, although it can occur at any age.
Smoking: Smoking has been shown to increase the risk and severity of thyroid eye disease, particularly in people with Graves’ disease.
Genetic Factors: There may be a genetic component to thyroid eye disease, as it tends to run in families.
Other Autoimmune Disorders: People with other autoimmune disorders, such as rheumatoid arthritis or lupus, may be at increased risk for thyroid eye disease.
The treatment for thyroid eye disease can vary depending on the type and severity of the condition.
For mild to moderate cases of Graves’ ophthalmopathy, treatment may include lubricating eye drops or ointments to relieve dryness and irritation, as well as medications to control the levels of thyroid hormones in the blood.
For more severe cases of thyroid eye disease, treatment may involve steroids or other immunosuppressive medications to reduce inflammation and swelling in the eye tissues. These medications can be given orally or through intravenous (IV) infusion, and may need to be continued for several months.
For cases where non-surgical treatments have proven ineffective or will likely do so you may also be referred to Thyroid Eye Disease Surgery for further treatment.
Yes, there are several surgical treatments available for thyroid eye disease, particularly for people with more severe symptoms or complications that cannot be effectively managed with non-surgical treatments.
Some types of thyroid eye disease surgery include:
Orbital Decompression Surgery: This procedure involves removing a portion of the bone around the eye to create more space for the swollen tissues, allowing the eyes to move back into a more normal position. This procedure can be performed through an incision behind the eyelid or through the eyebrow.
Eyelid Surgery: In cases of severe eyelid retraction or drooping, surgery may be necessary to reposition the eyelids and restore a more natural appearance. This may involve removing excess skin and fat, tightening the muscles around the eyes, or repositioning the eyelid margin.
Strabismus Surgery: Strabismus is a condition in which the eyes are misaligned, leading to double vision or difficulty focusing. Surgery can be performed to adjust the position of the eye muscles and correct the alignment of the eyes.
Other Treatments: In rare cases, other surgical treatments may be necessary, such as surgery to remove an enlarged thyroid gland (thyroidectomy) or to treat complications such as optic neuropathy or corneal ulcers.
It’s important to note that surgical treatments for thyroid eye disease are typically reserved for people with more severe symptoms or complications that cannot be managed with non-surgical treatments.