Thyroid Eye Disease

Although there is no thyroid gland in the eye or the orbit, the eye can be severely affected by thyroid disease. There are several thyroid conditions that can lead to a problem in the orbit, but the most common is entitled Graves’ disease.

In this condition, the immune system recognizes the thyroid gland as foreign and initiates an attack on the gland. The antibodies the immune system produces inadvertently cross-react with tissue in the orbit leading to an exuberant inflammatory response. This inflammatory response can produce a sensation of pressure, double vision, loss of vision, tearing, red eyes and the prominent eye.

Treating the thyroid gland and controlling the inflammation in the orbit is the first step to treat thyroid eye disease and Graves’ eye disease. Thyroid eye disease is a complicated condition that requires a team approach including a thyroid eye disease specialist. Our physicians can discuss the options for the treatment of your thyroid eye disease, as no two cases are the same.

In some cases, surgery is the best option. In other cases, patients can benefit from infusions of steroids or other medications like Tepezza (teprotumumab) or Actemra (tocilizumab). Tepezza is an infusion that was FDA-approved in 2020, and it has been shown to reduce eye bulging and double vision. It also improves the signs and symptoms of Thyroid Eye Disease (TED), including eye pain, redness, and swelling. Tepezza is not for patients with inflammatory bowel disease (Crohn’s or ulcerative colitis) or patients with uncontrolled diabetes. The most common side effects included high blood sugar, muscle spasm, tinnitus (ringing ears), muffled hearing, hearing loss, and gastrointestinal upset. According to some studies, nearly 90% of patients who start Tepezza are able to finish the treatment without having to stop due to side effects. Our physicians will work with you to figure out the best options.