Thyroid Eye Disease
What is thyroid eye disease?
Thyroid eye disease is most commonly associated with a disorder of the thyroid gland - hyperthyroidism and can also be known as Graves’ ophthalmopathy/orbitopathy and Thyroid Associated Ophthalmopathy (TAO). The effects of thyroid eye disease can include local inflammation, swelling and fibrosis of the eye structures, including the fat around the eye and in the muscles which move the eyes. It can sometimes occur in patients who have no thyroid dysfunction, or patients who have thyroid hypo-function. Most patients with thyroid problems do not develop an ophthalmopathy, or, if they do, it is only mild. A small proportion of patients who develop thyroid eye disease, may require treatment.
Thyroid eye disease has recognised stages. There is an early active phase, in which inflammation is present. This will usually last between 3 and 12 months before beginning to stabilise, becoming inactive. During the active phase maximal symptoms will develop, with eyelid retraction, eye protrusion and possible double vision and redness. If the active thyroid eye disease is treated early enough, it may be possible to reduce the severity of the disease and need for surgery.
What are the signs and symptoms of thyroid eye disease?
- Staring appearance with upper and lower eyelid retraction, resulting in more white of the eye being apparent
- Bulging or proptotic eyes, where the eyes protrude forwards and look very big
- Peri-ocular swelling, with puffiness of the eyelids, sub-brow area and peri-ocular region
- Orbital ache, particularly on eye movements
- Double vision (diplopia), either looking straight ahead, or on extremes of gaze
- Bloodshot appearance to the eyes associated with one or more of the above
- Reduced vision, particularly for colour vision, if the optic nerve is compressed