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Thyroid Eye Disease

Most patients with Grave’s disease, an autoimmune condition characterized by an over-active thyroid, will develop mild eye changes over the course of their disease. Some patients with other thyroid conditions, such as an under-active thyroid or a sudden inflammation of the thyroid, may also develop eye changes. Typical signs and symptoms include bulging of the eye, abnormal shape of the eye, double vision, pain and pressure behind the eye, glaucoma, and rarely, loss of vision due to pressure on the optic nerve. Typically both eyes are affected but often the involvement is asymmetric (one eye more affected than the other). When the eye changes are beginning to occur, which is most often within a year of diagnosis of the Grave’s disease, this is called the active phase of thyroid eye disease. Most cases are mild and will recur only supportive measures until the eye disease stops on its own. Sometimes patients will have vision-threatening changes during the active phase and will require treatment with corticosteroids or, rarely, surgery to decompress (make more room inside) the orbit. This is called an orbital decompression and involves removal of some bone to make more room for the eye and its associated tissue. In the inactive stage of thyroid eye disease, and depending on the severity of the eye changes, patients may require medical or surgical treatment. Thyroid eye disease may recur over time, and smoking has been proven to make it worse. Patients with Grave’s disease should be examined regularly by an orbital specialist.

Management of thyroid eye disease may be covered by your insurance. Call 203-791-2020 to schedule your thyroid eye disease evaluation with  Katherine J. Zamecki, MD, FACS.