Thyroid Eye Disease: Take Another Look

Portrait of Gary Joseph Lelli, Jr., M.D.

By Gary Joseph Lelli, Jr., M.D.

You feel it in your eyes and you see it in the mirror. Something is not quite right, but you’re not sure what. Maybe you have noticed one or both of your eyes are bulging out more, or your eyelids are swollen. Maybe you have persistent irritation – like dry, gritty, red eyes – or light sensitivity, pain and double vision. Perhaps you have been diagnosed with allergies, an infection or dry eye disease, but it is not getting better with treatment.

Individuals who are struggling with some combination of these symptoms may actually have a rare autoimmune disease called Thyroid Eye Disease (TED). TED causes the muscle and fat tissue behind one or both of the eyes to become inflamed and swollen. TED is a serious and progressive disease that often gets worse over time and can cause permanent changes to vision and appearance.

TED is most commonly seen in people with Graves’ disease – an autoimmune disease that causes the thyroid gland to produce an abundance of thyroid hormones. It can also occur in people with Hashimoto’s hypothyroidism or in patients with normal thyroid levels. Even if you have had your thyroid removed or you think your thyroid disease is under control, you may still be at risk for TED. TED is different from thyroid disease and must be diagnosed and treated independently.

Women are more likely to be affected, though men are more likely to have more severe symptoms of the disease. Other risk factors include smoking and age.

TED is a complex disease that is often misunderstood and misdiagnosed for allergies or an infection. But the good news is that we are raising awareness, improving our understanding of the underlying mechanisms and how the disease can be treated.

It’s a good idea to regularly visit your eye doctor for routine eye exams and monitoring. If you recognize these symptoms, and particularly if you have been diagnosed with Graves’ disease, make an appointment for an evaluation with a TED specialist, such as an ophthalmologist or an oculoplastic surgeon. It is critical to make the diagnosis as early as possible so that treatment options can be considered, before the disease progresses and may cause permanent damage to vision and/or appearance.

About Gary Joseph Lelli

Gary Joseph Lelli, Jr., M.D. specializes in ophthalmology at Weill Cornell Medicine in New York. Dr. Lelli is an oculoplastic surgeon and routinely treats patients with Thyroid Eye Disease.