Understanding Thyroid Eye Disease: Signs, Symptoms, Treatment Options, and Preventative Measures

Thyroid Eye Disease (TED) is a rare autoimmune condition that affects the eyes, often associated with hyperthyroidism or Graves’ disease. It can cause discomfort, vision problems, and cosmetic concerns, significantly impacting the quality of life. Understanding the signs, symptoms, and treatment options is crucial for early diagnosis and management.

Early intervention can significantly impact the course of the disease and prevent long-term complications. You should reach out to a doctor immediately if you experience sudden vision changes, persistent eye pain, or any rapid worsening of symptoms. Additionally, if you have a known thyroid condition and begin to notice any changes in your eyes, scheduling an appointment with a specialist can help in early detection and management of TED.

Signs and Symptoms of Thyroid Eye Disease

TED manifests through various symptoms that can vary in severity. Early detection is essential for effective management. Common signs and symptoms include:

• Bulging Eyes (Proptosis): One of the hallmark signs of TED is the outward bulging of the eyes, which occurs due to inflammation and swelling of the muscles and tissues around the eyes.
• Dry Eyes: Patients often experience dryness, irritation, and a gritty sensation in the eyes.
• Redness and Swelling: The eyes may become red and swollen, often accompanied by a feeling of pressure or pain behind the eyes.
• Double Vision (Diplopia): Swelling of the eye muscles can lead to misalignment of the eyes, causing double vision.
• Eye Discomfort: Many patients report a constant feeling of discomfort or pain in or around the eyes.
• Vision Changes: Blurred vision, light sensitivity, and in severe cases, loss of vision may occur as the disease progresses.

Treatment Options for Thyroid Eye Disease

TTED is categorized by its activity (active or inactive) and severity (mild to severe). Treatment aims to reduce symptoms, prevent complications, and improve the patient’s quality of life, with the approach depending on the disease’s stage:

• Medications:

• • Corticosteroids: Often the first line of treatment, corticosteroids help reduce inflammation. They can be administered orally or intravenously, with intravenous being more potent but also carrying more risks.
  • Tepezza and Biologics (Monoclonal Antibodies): Newer treatments, like Tepezza (Teprotumumab), have shown promise in reducing proptosis (eye bulging) and improving symptoms. Tepezza specifically targets the insulin-like growth factor-1 receptor (IGF-1R), which is overexpressed in TED. However, it’s costly and may have side effects such as muscle spasms, nausea, and hearing changes.
• Radiation Therapy: Orbital radiation can help reduce inflammation and swelling around the eyes in moderate to severe cases. However, it acts slowly and comes with potential risks, such as radiation retinopathy.
• Surgery: In advanced cases, surgical options may be necessary to restore normal eye function and appearance. These include:
  • Orbital Decompression: Removes parts of the bone to create more space for swollen tissues, often used in cases of compressive optic neuropathy or severe cosmetic concerns.
  • Strabismus Surgery: Corrects eye muscle alignment to address double vision.
  • Eyelid Surgery: Repairs eyelid retraction to improve both function and appearance.

Preventative Measures for Thyroid Eye Disease

While TED cannot always be prevented, certain measures can help reduce the risk or mitigate the severity of symptoms:

• Quit Smoking: Smoking is a known risk factor for TED and can worsen the condition. Quitting smoking is one of the most effective ways to reduce the risk of developing or exacerbating TED.
• Regular Eye Exams: For those with thyroid conditions, regular eye exams can help detect early signs of TED, allowing for timely intervention.
• Manage Thyroid Levels: Keeping thyroid hormone levels stable through appropriate medication and regular monitoring can help reduce the risk of TED.
• Protect Your Eyes: Wearing sunglasses to protect your eyes from UV rays and wind can help alleviate symptoms like dryness and irritation.

Exciting News: Upcoming Clinical Trials for TED Medications

At California Oculoplastics and Retina, we understand the challenges faced by patients whose insurance doesn’t cover Tepezza. We are excited to announce that we will soon be rolling out clinical trials for new TED medications. These trials will offer access to cutting-edge treatments for eligible patients, providing an alternative for those seeking relief from this challenging condition.

If you or someone you know is experiencing any signs or symptoms of Thyroid Eye Disease, or if you’re interested in learning more about our upcoming clinical trials, please don’t hesitate to contact our office at 626-653-9395. We’re here to provide information on all available treatment options and support you in your journey to better eye health.