Thyroid eye disease (TED) is an autoimmune disorder that affects the tissues around the eyes. The condition is most frequently linked to hyperthyroidism, a condition in which the thyroid gland overproduces the thyroid hormones.
However, individuals with normal thyroid function may also develop thyroid eye disease. Here are 5 warning indications of thyroid eye disease that you should be aware of.
1. Bulging eyes
Proptosis, or bulging eyes, is one of the most prevalent signs of thyroid eye disease. This happens when the fat tissues and muscles that support the eyes in the eye sockets or orbits swell and inflame, forcing the eyeballs forward. Bulging can range in severity from minor to severe. In severe cases, the eyes cannot close fully. If the cornea is exposed and dry, bulging eyes may result in pain, dryness, irritation, and may lead to severe corneal infections. In these cases, there is potential threat to vision. It must also be kept in mind that when bulging is severe, there may also be compression of the optic nerve by the swollen orbital tissues. If present, urgent attention is required to avoid vision loss.
2. Retracted eyelids and a staring appearance
The look of the eyelids might also change as a result of thyroid eye disease. Aside from the eye bulging mentioned above, the eyelids may swell and become red and puffy due to the inflammation. The upper eyelids may retract or pull upwards as a result of thyroid eye disease, giving the patient a startled or wide-eyed staring expression. This retraction may also be seen in the lower eyelids with the lower eyelids being pulled downwards, adding to the staring appearance. In severe cases, lid retraction, together with eye bulging, leads to incomplete eye closure with potential threat to vision. The resultant altered appearance can also affect a patient’s self esteem.
3. Double vision
Diplopia, also known as double vision, is another symptom of thyroid eye disease. This happens when the muscles that move the eye swell and become inflamed and tight, causing the eye movements to become restricted. Double vision may be more obvious when an individual is tired or gazing in certain directions. Driving, reading, and working may all be made difficult by double vision.
4. Blurred vision
A decrease in vision occurs when the optic nerve of the eye is compressed by the swollen orbital fat and eye muscles. This develops in the posterior or back portion of the eye sockets or orbits where the space is tightest. Blurred vision can also be due to chronic eye dryness or corneal infection secondary to the increased eye exposure. If a patient experiences a drop in vision, urgent attention is required to avoid permanent loss of vision.
When the eye surface is dry, a reflex increase in tear production results and can overwhelm the tear drainage system. Tearing is then experienced by the patient. Tearing can also be due to incompetent tear drainage as seen when the eyelids cannot close fully in cases with severe eye bulging and lid retraction.
It is crucial to seek medical attention soonest if you encounter any of these symptoms or signs. An oculoplastic surgeon will conduct a comprehensive examination and suggest the best course of action. Thyroid eye disease is a complex eye disorder that is best managed by an oculoplastic doctor.
Therapeutic measures will depend on whether the disease is in the active phase or has burned out and is in the inactive phase. Generally speaking, immunosuppression and radiotherapy are options in the active phase whereas surgery may be required in the inactive phase. However, surgery may occasionally be required in the active phase if optic nerve compression is encountered and does not respond to non-surgical medical treatment.
Ava Eye Clinic is a specialised eye care centre that offers a wide range of services, including thyroid eye disease management, droopy eyelids correction and cataract treatment in Singapore. We are committed to providing excellent and compassionate care to all of our patients.
Please contact us for more information and an appointment where appropriate.