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LifeLine: A Doctor’s Insight

LifeLine: A Doctor’s Insight

All Eyes on Thyroid Eye Disease 

Nearly 20 million people are affected by Thyroid Disease in the US. Women are 5 times more likely to develop this condition than men. Thyroid Eye Disease can occur on its own or in conjunction with Hyperthyroidism or Grave’s Disease. Not all people with a thyroid disorder will develop Thyroid Eye Disease. Having a known thyroid condition or family history increases your risk of developing Thyroid Eye Disease. This is a rare and vision threatening autoimmune condition that causes the muscles and the fatty tissues behind the eye to become inflamed and enlarged, leading to bulging of the eyes and facial disfigurement. In addition to the bulging eyes, or proptosis, patients can experience double vision and light sensitivity. These changes can ultimately lead to blindness. 

Persons who are currently diagnosed with Thyroid Eye Disease or persons who are concerned they may have this condition should monitor for certain ocular changes. Changes typically occur during the active or inflammatory stage of the disease. This stage can last between 6 months and 2 years. Look for: 

Eyelid retraction. Where one or both of the upper eyelids sits in a higher position than it had in the past. Your eyes may look bigger in current pictures of yourself versus those of a few years past. It may also be more difficult to fully close your eyes. 

Swollen puffy eyelids. This symptom can easily be confused with allergies. Remember allergies will have accompanying sinus involvement and itching. Allergies are also seasonal. 

Bulging eyes. This symptom may occur in one or both eyes. Changes will be noted over time. Referencing past photos maybe helpful. 

Dry, gritty eyes. 

Chronic redness.

Excessively watery eyes. 

Pain or pressure behind or around your eyes. 

Light sensitivity. 

Blurred and double vision. 

Autoantibodies working behind the eye cause long-term damage to orbital structures. After the inflammatory or active stage is over you enter the stable or non-active stage. In the past, any changes to ocular structures that occurred during the active stage were nearly permanent. A few surgical options exist to correct for bulging of the eyes and double vision. These surgical options are not with out their own risks. 

A new option now exits. A new drug, Teprotumunab, has recently been approved by the FDA to treat Thyroid Eye Disease. A recent study published in the New England Journal of Medicine has shown the drug to not only halt the active inflammatory stage but also to reverse its damaging effects. In the double blind study 86% of the patients treated experienced improvement in symptoms, appearance and quality of life. Improvements were seen in as few as 2 treatments. Treatments are available now. Those affected by Thyroid Eye Disease should discuss options with their Endocrinologist. 

Dr. Cameron is the owner and operator of Cameron Optical in Montgomery, Texas. Get routine eye exams to ensure you maintain a healthy vision.

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