Thyroid Eye Disease (TED)

Thyroid eye disease is an autoimmune condition, usually associated with Graves’ disease and less often with hypothyroidism and euthyroidism. Patients with thyroid eye disease typically experience proptosis, eyelid retraction, and inflammation around the eyes and, thus, corneal exposure, eye irritation, and/or pain, redness, blurry vision, double vision, or tearing. Only about 5% of patients with Graves’ disease develop thyroid eye disease that is severe enough to require medical attention. For those severe cases, the surgeon will generally recommend medical treatment first and then surgical treatment.

Medical treatment may be as conservative as lubrication of the cornea or as intense as IV steroids or a steroid-sparing anti-inflammatory agent. Systemic medication is administered in collaboration with the endocrinologist. Surgery ranges from orbital decompression, muscle realignment, or retraction repair. In rare instances, emergent surgery (orbital decompression) is necessary to save vision from compression of the optic nerve or corneal erosion and thinning. 

Most patients with thyroid eye disease require multiple surgeries before restoring comfort to the eye and a normal appearance. This all depends on the severity of the disease. Of the risk factors related to thyroid eye disease, smoking is a strong and important factor that can be mitigated.