How to Recognize TED: Identify Common Symptoms of Thyroid Eye Disease

Thyroid Eye Disease (TED), also known as Graves' orbitopathy or thyroid-associated ophthalmopathy, is a serious condition that occurs when the immune system mistakenly attacks tissues around the eyes, leading to inflammation and a variety of symptoms. These symptoms can range from mild irritation to severe complications such as visual impairment or changes in the appearance of the eyes.

Thyroid eye disease (TED) is a serious and complex eye condition that occurs when the immune system mistakenly attacks tissues around the eye, causing inflammation and other complications. Despite its seriousness, TED is often confused with more common eye problems such as allergies, conjunctivitis, or dry eyes, which can delay diagnosis and treatment. Early detection of TED is critical, as symptoms tend to progress over time and can lead to more serious complications such as visual impairment or permanent changes in the appearance of the eye. Understanding the subtle and insidious symptoms of TED can play an important role in catching the condition early, improving the chances of effective treatment and better outcomes. This article describes the symptoms of TED, provides insight into its prevalence, and examines available treatment options to effectively manage the condition.

Common Signs and Symptoms of Thyroid Eye Disease (TED)

The symptoms of TED range from mild irritation to more serious changes that affect vision. Here are common signs to watch for:

Protruding eyes (exophthamos):One of the cassic symptoms, exophthamos occurs when the eye protrudes or buges out due to infammation and expansion of tissue around the eye socket. This symptom usuay comes on graduay and may go unnoticed initiay.
Dryness and irritation:Many peope with TED experience dryness, redness, and discomfort that mimic common dry eye symptoms. However, typica over-the-counter medications provide imited reief.
Eyeid sweing or retraction:Eyeid sweing or retraction is common in TED and can make the eyes ook "stiff" and may be confused with aergies or conjunctivitis.
Diptyopia (doube vision):Sweing of the musces behind the eyes can cause doube vision, especiay when ooking in certain directions. If eft untreated, TED-reated doube vision can become more severe over time.
Eye pressure or pain:Constant feeings of pressure, discomfort, or even pain around the eyes are common, especiay with movement or straining.
Sensitivity to ight (photophobia):Eye infammation in TED can ead to increased sensitivity to ight, a symptom that is often confused with migraines or other conditions.
Difficuty moving the eyes:When eye musces swe and become stiff, decreased mobiity or restrictive myopathy may occur. It may be difficut for the patient to ook in certain directions without discomfort or doube vision.

The intensity of these symptoms varies, and some may be gradual or subtle at first, making the progression of TED very different from person to person. If these symptoms persist, a consultation with an ophthalmologist is recommended.

Thyroid-related eye disease may be more common than you think

Although TED appears to be a rare disease, it is actually relatively common in people with thyroid disease. Studies have shown that TED affects approximately 50% of people with thyroid disease in white people. For the general U.S. population, the annual incidence is approximately 16.0 cases per 100,000 people in women and 2.9 cases per 100,000 people in men (Source: National Library of Medicine).

TED tends to show a bimodal peak incidence pattern, with peak ages of 40 to 44 and 60 to 64 for women and peak ages of 45 to 49 and 65 to 69 for men. Older patients may experience more severe cases, with an increased risk of restrictive myopathy and dysthyroid optic neuropathy (DON) (Source: National Library of Medicine).

Environmental factors: Smoking has a strong association with TED, as smoking is thought to worsen symptoms and increase the likelihood of developing the condition. Managing environmental factors such as quitting smoking can reduce TED risk and help improve outcomes.

Available treatment options for TED

The primary treatment for TED depends on the severity of symptoms. One of the most effective options is Tepezza (teprotumumab), a drug designed specifically for TED. Tepezza targets proteins that cause inflammation and tissue swelling in the eye. It helps reduce symptoms such as bulging eyes, double vision, and has a significant effect on improving appearance and vision (Source: Tepezza).

In milder cases, lubricating eye drops or sunglasses can relieve dryness and light sensitivity. In severe cases, surgery such as orbital decompression may be necessary to preserve vision (Source: Thyroid Eyes).

Final thoughts

Recognizing the symptoms of TED allows for early intervention and the potential to stop the progression of the disease. Awareness of the prevalence of TED and associated risk factors has enabled those affected to seek specialized treatment promptly. If you or someone you know has persistent eye symptoms or a history of thyroid disease, you should see an ophthalmologist for further evaluation.

Thyroid Eye Disease (TED), Graves Orbitopathy, Exophthalmos (Protruding eyes)