THYROID EYE DISEASE

Thyroid eye disease is an inflammatory disease of the eye and the surrounding tissues. The inflammation is due to an autoimmune reaction - the body's immune system is attacking tissues within and around the eye socket.

The most common signs and symptoms associated with TED are:

1. Upper and/or lower eyelid retraction: the eyelid is retracted up or down from its normal position ,this gives an appearance as if the patient is “staring” or is “frightened”

2. Dry Eyes: In cases of severe retraction, the ocular surface is exposed more which can lead to tearing, foreign body sensation, and blurred vision.

3. Exophthalmos/Proptosis: It looks as if the eyeball is bulging out of the eye socket. This can lead to dry eye and can also damage the cornea in severe cases. Sometimes it can also cause double vision

4. Squint: there is swelling of the muscles that control eye movements in thyroid eye disease, this can lead to restriction of the movements of the eye and can lead to double vision

5. Optic nerve dysfunction: Too much of swelling of the muscles and tissues surrounding the eye leads to increase in pressure in the bony socket around the eyes and this can lead to damage to the optic nerve. This can manifest as decrease in the colour vision or decrease in clarity of vision.

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Treatment :

1. Lid surgeries: To correct the lid retraction

2. Management of Dry Eyes: require lubricating eye drops, gel or sometimes taping of the eyes at night. Some severe  cases may need tarsorrhaphy

3. Orbital decompression: this surgical procedure may be needed if there too much protrusion of the eyeball or if the optic nerve is compressed

4. Management of Squint: requires prisms in some case and some cases may need surgery