Thyroid Eye Disease
Thyroid eye disease is one of the most common conditions Dr. Eftekhari treats in his practice. Many patients in the general population have thyroid disease, and a common condition is high thyroid or Graves’ disease. In Graves’ disease, patients may experience weight loss, palpitations, tremors, and other systemic symptoms. About one-third to one-half of patients with Graves’ disease will also develop changes around their eyes. The reason for this change is because some patients develop antibodies in their bodies that cause growth of the fatty and muscular tissue in the eye socket and can cause scarring.
Symptoms of Thyroid Eye Disease
The symptoms and signs of thyroid eye disease can initially be non-specific, with many patients saying their eyes have more tearing, redness, irritation or simply puffiness around their eyes. If you have these symptoms and you have a history of high or low thyroid, discuss this with your thyroid specialist and consider calling our office for a consultation.
More severe cases of thyroid eye disease show changes around the eye including bulging of one or both eyes (proptosis), lifting up of the upper eyelid on one or both sides or pulling down of the lower eyelid (eyelid retraction, and rarely double vision because of a scarred eye muscle.
Typical Course of Thyroid Eye Disease
In many patients, the signs and symptoms of thyroid eye disease will increase and peak over the course of a few months, and then partially subside. This process historically can take 18 to 24 months to run its course, although there is significant variability. In almost all patients, their eyes may get a little bit better but do not return to their previous state or appearance.
Treatment for Thyroid Eye Disease
For patients who have significant signs of thyroid eye disease, Dr. Eftekhari may recommend treatment. Traditionally this consisted of weekly steroid infusions or oral steroids, both of which have many side effects. For some patients, there is a new infusion medication that was just approved by the FDA for thyroid eye disease, the first medication in its class approved for this condition. This medication is for active thyroid eye disease and is called Tepezza (teprotumumab). Dr. Eftekhari may recommend this medication depending on the signs and symptoms of the disease.
For patients who do not respond to medical therapy or who have chronic thyroid eye disease with scarring, Dr. Eftekhari may recommend surgery. Some surgery is directed at creating more space in the eye socket for the bulging eye to retrude back into the eye socket (orbital decompression) and other surgery is directed at addressing abnormalities of the eyelids (eyelid retraction surgery). Dr. Eftekhari has extensive experience performing these surgeries.
If you have thyroid disease and have noticed changes around your eyes, or if you have been recommended to have radioactive iodine (which can worsen pre-existing eye disease), please call our office for a consultation.