Treatment for Thyroid Eye Disease


Thyroid eye disease has a number of noticeable symptoms, including discomfort and dryness, in the early stages of the condition. As the swelling increases, you may start to have bulging or staring eyes (which makes many people feel very insecure about their appearance). When the lids and muscles are affected, dryness may become worse and you may develop double vision. Diagnosis can be made based either on a measurement of your eyes bulging, by images of your eyes with a CT scan or MRI, and/or tests for Grave’s Disease.

Following the diagnosis and assessment of thyroid eye disease, you will have a course of treatment based on the severity of your symptoms and the functioning of your thyroid. Because the disease involves both the endocrine system and your eye sight, chances are both your physician and your ophthalmologist will work together to treat your condition.

Mild Symptoms

If your symptoms are not too severe, such as grittiness or mild discomfort, you may not need much additional treatment for your eye problem. Eye drops to keep your eyes lubricated may be recommended. Your physician may suggest sleeping propped up and avoiding anything that might cause greater discomfort, such as exposure to dust or wind. Sunglasses may be recommended for outdoor and sometimes indoor use to help minimise discomfort. Also, cold compresses can be used to reduce the swelling.

Because you may have double vision even if your symptoms are not more severe, you may receive treatment for that, too. Those options are discussed further in the article.

Treating Grave’s Disease

If you have symptoms of Grave’s Disease as well, your doctor may want to treat that problem before doing too much with your eye troubles. That’s because as long as the thyroid isn’t functioning correctly your eyes probably will still be having the same problem and therefore it doesn’t make sense to treat the latter first.

Your thyroid problem may first be treated with medications. Beta-blockers can be used to stop some of your thyroid’s functioning while anti-thyroid medications can also be used to stop the production of hormones at such high levels. Unfortunately, the former medications do not cause the problem to go away and are only useful as part of additional treatment while the latter is used for only a small number of patients and rarely provides long lasting results.

The best results are usually gained with radioactive iodine treatments. With this you’ll have to drink radioactive iodine which will end up in the thyroid and will slowly kill off the cells causing the over-activity. This is not a fast treatment, however. Results can take as long as three months to start showing up and even once the thyroid goes back to normal you may need to continue taking the treatments for a short time so your endocrinologist can make sure your thyroid is producing sufficient levels of hormones.

The surgical removal of the thyroid is usually considered a last resort. Once it is removed, you’ll have to remain on hormone therapy for the rest of your life to make sure your levels stay normal.

Treatment Options for Thyroid Eye Disease

Typically, medication is used as the first resort. Prednisone, which is a corticosteroid, is usually used to help stop the inflammation. This is known as immunosuppressive therapy because the medication actually slows down the immune response which gives the tissue a chance to heal and to recover from the attacks. Instead of steroid treatments like this one, some physicians will use radiotherapy which has fewer side effects.

Unfortunately, steroid treatments can have a wide range of side effects including weight gain and bone loss. For this reason, physicians may not recommend any type of treatment – besides that to deal with the mild symptoms – unless you are having problems with your vision.

If your vision problems do worsen and/or immunosuppressive treatments do not work effectively, surgery may be the next recommendation. To relief pressure on the eyes, a surgeon can actually remove a portion of the bone near your sinus cavity so the tissue can swell into that area without causing any more damage to your eyes. The surgeon can also operate on your eyelids so they will close all the way and, therefore, minimize your discomfort.

Treatment for Double Vision

Because thyroid eye disease does usually clear up on its own, many doctors won’t spend much time treating the condition itself. Instead, they are more likely to treat the symptoms, including double vision.

Three main treatments are used for double vision:

  • Occlusion

  • Prisms

  • Surgery

With occlusion, you just have to wear a patch or other covering over one of your eyes to force yourself into seeing just one image instead of two. Basically, its a system of retraining your eyes. Prisms can be built into eyeglass lenses to allow you to see by light bouncing off the prisms. If these options do not provide satisfactory results, you may need to have a surgeon de-attach your eye muscles and re-attach them elsewhere on your eye.

Prevention of Thyroid Eye Disease

While there are some treatments that can help once you develop the disease, taking steps to prevent it from occurring is usually going to be the best course of action. Unfortunately, there are not that many ways to prevent it.

To help prevent Thyroid Eye Disease it is advisable to either not smoke or to quit smoking. One of the biggest risk factors seems to be smoking so this is a good way to reduce your risk and prevent these eye problems. Smoking is also believed to interfere with treatment of the condition and of Grave’s Disease.  If you have a history of thyroid problems or if you have a family history of thyroid eye disease/Grave’s Disease specifically, you should make sure to monitor your thyroid’s performance carefully. By recognising problems early on, treatment can be delivered quickly and may stop the eye problems from becoming too severe.

Although the symptoms associated with thyroid eye disease do often go away in less than two years, they may permanently change the look of your eyes and face. That is because the swelling and inflammation may eventually convert into scar tissue that cannot be removed by medications. Some people consider plastic surgery to help reduce the appearance of the puffiness or the bulging of the eyes.

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