Thyroid eye disease is an autoimmune disorder that generally occurs in conjunction with the thyroid disorder called Grave’s disease. For reasons unknown, the disease attacks the tissue around the eye, causing it to swell and push the eyeballs outward, giving the person a wide-eyed staring appearance. It has been seen in patients with no thyroid disease at all. Not all thyroid disease patients get the eye disorder.

Symptoms

Thyroid eye disease is a physically obvious disorder that causes the eyes to bulge out away from the face. This sign is called exophthalmos. Other symptoms may include one or more of the following:

• Pain, especially with movement
• Dry, irritated eyes
• Double vision
• Blurred vision
• Light sensitivity
• Redness (bloodshot eyes)
• Swelling that affects the optic nerve that may lead to vision loss
• Color blindness

The majority of people with thyroid eye disease will only experience dryness, pressure and redness.

Treatment

The mildest symptoms such as dryness and itching can be treated with lubricating eye drops used during the day and at night while you sleep. Symptoms tend to be worse in dry weather; use a humidifier in your home to add moisture back into the air. Wraparound sunglasses worn outside help alleviate light sensitivity.

Vision problems can often be treated with corrective glasses. Long-term use of corticosteroids is not suggested and may cause permanent scarring of the eyes.

A small percentage of patients will require surgery to correct vision problems caused by the onset of thyroid orbital eye disease. Mild double vision can be corrected with prism glasses. When severe, eye muscle surgery can be considered.

Treatment of the underlying thyroid disease will, over time, cause the puffiness and outward bulging of the eye to diminish. This often takes a long time, but may eventually improve. In some cases, patients have chosen to have plastic surgery to correct the eyes’ appearance.