What is TED?

What is Thyroid Eye Disease?

Thyroid Eye Disease (TED) is an autoimmune disease affecting the tissues around the eye. It usually leads to forward protrusion of the eyes, swelling, and double vision. The normal look of the eye can be lost, giving a staring or scary look.

Who gets Thyroid Eye Disease?                                                                                                                                    Patients with thyroid disorders (Hyderthyroidism, Hypothyroidism, Graves’ disease) are at risk. Approximately 25-30% of them may develop the ‘eye disease’ (TED). Of these, only a few (2%) will have severe eye disease. Rarely, it may commence during pregnancy. It is not necessary to have abnormal blood thyroid levels to develop eye disease. Especially in India, many patients develop the eye disease even when blood levels are normal (Euthyroid eye disease).

What changes around the eye?

In a normal person, the amount of fat behind the eyeball is constant and the eye muscles  move normally. In Thyroid eye disease, the fat behind the eye increases, and eye muscles begin to swell. This causes the eye to protrude. Simply put, the tissues behind the eye enlarge, making the eye prominent. If eye muscles are involved, eye movement may get affected, leading to double vision.

What happens next?

Thyroid eye disease has two phases: an active phase followed by a stable (inactive) phase.The active phase lasts for a year, and then enters the inactive phase. In active phase, we mostly observe or treat medically. In the inactive phase, surgical correction is planned.

The active phase can be simply compared to a house on fire. While it is on flames, the doctor focuses on extinguishing the fire (redness, swelling) with fire-extinguishers (steroids). The house cannot be rebuildwhile the fire is still on!

Once the thyroid eye disease has become inactive, it is time to perform corrective surgeries that will rectify the damage caused during the active stage. This can be compared to the repair of the house carried out after the fire is successfully controlled.

So if we see you during the active, phase, we wait and watch for the fire to extinguish (with or without medications). If we see you during the inactive phase (>1 year since onset), we usually discuss corrective surgeries to bring back your normal looks.