Thyroid Eye Disease or (TED), is an autoimmune disorder that affects the retro-ocular (situated behind the eye) eye tissue. Thyroid-Associated Orbitopathy or (TAO) usually affects both of your eyes and occurs when you have been diagnosed with an overactive thyroid or hyperthyroidism.
Thyroid eye disease is also referred to as Graves’ disease which is an autoimmune condition where immune cells attack your thyroid gland. Your thyroid then responds by secreting an excessive amount of thyroid hormone (the hormone that controls your body’s metabolism) When your immune system does not function the way it should, it can lead to inflammation that causes the tissue and muscles around your eyes to become puffy.
Causes of Thyroid Eye Disease
When you have thyroid eye disease, your body mistakes the tissue surrounding your eyes for a foreign body or invader. Your immune system in-turn sends out antibodies that attack that tissue, muscle, and fat in and around the eye
Symptoms
Because thyroid eye disease mostly affects the area in your skull where your eyeballs sit (orbit), it can make your eyes bulge. Other symptoms can include:
- Sensitivity to light
- Pressure and pain in the eye
- The sensation of dirt in your eye
- Watery or dry eyes
- Eye redness
- Double vision
Treatment
Thyroid eye disease is a vision-threatening problem that can be treated with medications, radiation and surgery. If your vision is seriously threatened, you may need a combination of these.
- Medications – include corticosteroids or other anti-inflammatory medications
- Radiation therapy – this is used to target the inflammatory cells.
- Surgery – involves a procedure called Endoscopic orbital decompression. It is performed to remove the middle and bottom walls of the bone surrounding the eye.
Orbital Diseases & Treatment
Orbital inflammatory diseases are a collection of inflammatory disorders that affect your orbit. These can include:
- Dacryoadenitis – inflammation of the lacrimal gland (tear-producing gland) Treatment for this can include broad spectrum antibiotics and abscess drainage.
- Ocular myositis – this is a rare inflammatory disorder of the extra-ocular eye muscles. Treatment includes oral corticosteroids. If these do not work, other options include radiation therapy, IVIG (Intravenous Immunoglobulin infusions), T-cell inhibitors, and antibiotic therapy.
- Optic perineuritis – also a rare disease that targets the optic nerve sheath. Treatments include high doses of prednisolone, steroid pulse therapy (a high daily dose of intravenous steroids over a short period of time)
- Orbital tumours – these are abnormal growths of tissue in the structures that surround your eye. Treatment depends on the type of tumour you have but can include careful removal of the tumour using surgical techniques.
- Orbital cellulitis – an infection of the skin and tissues around the eye. If antibiotics do not work, surgery will be performed and involves drainage of the area or the abscess.
- Episcleritis – an inflammatory condition that affects the episcleral tissue between the conjunctiva and the sclera (the white part of the eye) Treatment includes artificial tear eye drops, corticosteroid eye drops, and non-steroidal anti-inflammatory drugs
If you have experienced a sudden onset of pain along with swelling and inflammation in the orbital area, you could have and orbital disease. It is crucial that you consult with Dr Vayanos as soon as possible for a proper examination so that she can diagnose and treat your specific condition.
Dr Vayanos is a general Ophthalmologist in full-time private practice at the Netcare Christiaan Barnard Private hospital in the centre of Cape Town, South Africa. One of her areas of expertise includes treatment and surgery for thyroid and orbital diseases.
Her practice is equipped with the latest technology allowing her to give you personalised, quality, and high-standard eye care and surgical precision. If you suspect you may have any of the above mentioned conditions, we suggest you set up an appointment with Dr Marianthy Vayanos as soon as possible.
Have any questions on thyroid eye disease or orbital diseases? We are here to help. If you do not find your answer below, get in touch with us and we will do our best to provide it.
Thyroid Eye Disease (TED), also referred to as Graves’ disease, is an autoimmune condition that affects the tissues located behind the eyes. Typically affecting both eyes, Thyroid-Associated Orbitopathy (TAO) commonly arises in individuals diagnosed with an overactive thyroid, also known as hyperthyroidism.
Medical treatment can significantly improve these conditions; however, some patients may require a combination of medication and surgery to alleviate their symptoms. Some patients experience permanent changes, while others see their eyes return to normal.
Thyroid Eye Disease (TED) is caused by inflammation and scarring resulting from an autoimmune attack. It is primarily associated with an overactive thyroid gland due to Graves’ disease, though it can also rarely occur in individuals with an underactive or normally functioning thyroid gland.
Fluctuating thyroid hormone levels can frequently worsen Thyroid Eye Disease (TED). In TED, the immune cells responsible for attacking the thyroid gland in Graves’ disease also target the adipose (fat) and fibroblast tissues surrounding the eyes.
Orbital infections, also known as orbital cellulitis, can be highly aggressive and pose a serious threat to vision. In rare instances, these infections can be life-threatening. They most commonly arise from infections in the adjacent sinuses but can also result from minor skin breaks or trauma.
Signs and symptoms of orbital inflammatory disease include a sudden onset of pain along with swelling and inflammation in the orbital area.
Mild cases may resolve without treatment, while more severe cases typically respond well to corticosteroids. In extreme instances, swelling can exert pressure on the eyeball and cause damage. Surgery might be necessary to remove part of the orbital bones to alleviate this pressure.
Treatment for orbital tumours depends on the type of tumour you have. Surgery is typically a cure for benign tumours. For rare malignant tumours, surgery may be supplemented with radiation and chemotherapy.