Thyroid Eye Disease
WHAT IS THE THYROID?
The thyroid is a butterfly-shaped gland on the front of the neck. It makes a hormone that controls how your body uses energy, your metabolism. It controls how fast or slow your body works.
WHAT ARE EUTHYROID, HYPERTHYROID, AND HYPOTHYROID?
Your thyroid can work in 3 main ways:
- Euthyroid: When the thyroid makes the right amount of hormone.
- Hyperthyroid: When the thyroid makes too much hormone.
- Hypothyroid: When there is not enough hormone.
Too much or too little hormone can cause problems.
WHAT ARE THE SIGNS OF HYPERTHYROID AND HYPOTHYROID?
Too much thyroid hormone (hyperthyroidism) can cause you to:
- feel tired
- have a fast heartbeat
- lose weight
- feel too hot
- Have thinning hair
- Have diarrhea
Too little thyroid hormone (hypothyroidism) can cause:
- tiredness
- slow heartbeat
- constipation
- weight gain
WHAT IS THYROID EYE DISEASE?
Thyroid eye disease is when the thyroid hormones are not normal and it affects the eyes. It happens most commonly with Grave’s disease. Graves’ is when the body attacks its own healthy parts. The body attacks the thyroid gland, causing too much or too little thyroid hormone. The body also attacks the area around the eyes, causing thyroid eye disease.
Thyroid eye disease can occur at any age, but the main age is 45 years. It is more common in women and in people with other autoimmune diseases (where the body attacks itself).
People who smoke are more likely to get thyroid eye disease and more likely to have worse symptoms.
CAN YOU GET THYROID EYE DISEASE WITH NORMAL THYROID LEVELS?
YES! Even people with normal thyroid hormone levels can have thyroid eye disease. The body can still attack the eye tissues.
DOES THE THYROID ABNORMALITY ITSELF CAUSE EYE DISEASE?
No, the thyroid problems and the eye problems are independent manifestations of the underlying autoimmune abnormality and the abnormal antibodies. It is important to realize that thyroid eye disease can occur even when a patient is euthyroid.
WHAT HAPPENS TO YOUR EYES IN THYROID EYE DISEASE?
Thyroid eye disease often causes swelling around the eyes. This can make the eyes watery, red, irritated, and painful with bright light. Sometimes the eyes look like they’re bulging (Figure 1). Thyroid eye disease can cause double vision or blurry vision, because the eye swelling can push on the optic nerve (that connects the eye to the brain) or the eye muscles (Figure 2).
Figure 1: the eyes are wide open, red and look like they are bulging from thyroid eye disease.
Figure 2: there is swelling on the eyelids and one of the eyes is pointed down from thyroid eye disease.
HOW IS THYROID EYE DISEASE TREATED?
It is important to work with doctors who treat both thyroid and eye problems. The first step is to control the thyroid hormone levels. Eye problems need to be treated at the same time. Treatment depends on how bad the disease is, and treatment can take a long time.
Thyroid eye disease can be split into three stages:
- Stage 1: Acute stage: The goal is to control hormone levels. This might need medicine or surgery. Vision problems may need urgent treatment, such as steroids, surgery, or special medicine (like teprotumumab).
- Stage 2: Stable stage: The disease is less active, but there are still problems like bulging eyes, double vision, and eyelid issues. Surgery may be needed to help with eye bulging and eye alignment.
- Stage 3: Eyelid surgery: Surgery may be performed to help improve how the eyelids look and work after the other treatments have been done.
People with thyroid eye disease need lifelong care and check-ups with their doctors. The disease can come back later in life.
WHERE CAN I GET MORE INFORMATION ABOUT THYROID EYE DISEASE?
Updated 11/2024
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