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Thyroid eye disease (TED) is an autoimmune disorder that can cause uncomfortable eye symptoms. If you have TED, you might experience irritation and pain. Other symptoms of thyroid eye disease include:
TED is a common condition among people with Graves’ disease. For this reason, TED may also be called Graves’ eye disease or Graves’ ophthalmopathy. Graves’ disease can cause hyperthyroidism, in which the body releases too many thyroid hormones. However, a person can also develop TED without having Graves’ disease, even with normal thyroid hormone levels.
Thyroid issues are usually treated by an endocrinologist. If you have TED in addition to Graves’ disease, you will need care from an ophthalmologist. They can help you treat TED and manage any pain you may be experiencing.
The following are some tips you might find helpful to relieve your TED pain and improve your quality of life.
You can buy eye drops (also called artificial tears) at the pharmacy. Over-the-counter eye drops are the most common way to treat dry or irritated eyes since they have a lubricating effect, keeping the surface of your eye moist.
Some eye drops also decrease the evaporation of your tears, keeping your eye’s surface moist. Some also contain elements that make the solution more viscous (thicker), enabling it to stay on your eye for a longer period.
Some artificial eye drops have preservatives, while others don’t. If you have moderate to severe dry eyes, you might want to get preservative-free eye drops, especially if you’re applying artificial tears more than four times a day.
Artificial tears can also come in the form of gels or gel inserts. Like eye drops, you can get these over the counter.
Because gels and ointments are thicker than liquid artificial tears, you might have blurry vision for a little while after you apply them. Gels and ointments should not be applied over contact lenses, as they might stick to them.
Make sure to watch out for side effects that could indicate an allergic reaction, such as itching and swelling. If you experience these symptoms, seek medical help.
One way to relieve eye pain or irritation is by using cool compresses. Run a washcloth or hand towel under cool water until it’s moist, then place it over your closed eyes. Make sure the cloth is clean before using it.
Lying down with your head at a higher elevation than the rest of your body can help keep your eyes more comfortable. You can do this by using extra pillows to prop up your neck.
Because sensitivity to light is a symptom of TED, you might find some relief from wearing sunglasses when you’re outside. Look for frames that give you good coverage to best protect your eyes.
An important but longer-term way to relieve TED-related eye pain and irritation is to quit smoking, as smoking worsens Graves’ disease. Treatments for TED can also be less effective in people who smoke.
Smoking increases a person’s risk of developing TED by seven or eight times. For those who have TED, smoking can prolong the active phase of the disease.
Making lifestyle changes or trying new treatments for TED can be difficult, but you are not alone. Your doctor can help guide you as you work to stop smoking. It’s also important to have a support system, whether this is friends, family, or others who know what you’re going through.
Your ophthalmologist may also suggest treatment for TED itself. Below are some potential treatment options.
Your provider might prescribe steroids, such as prednisone, to reduce the swelling behind your eyes. Additionally, a medication called teprotumumab (Tepezza) is approved by the U.S. Food and Drug Administration (FDA) to treat TED.
Selenium supplements, which are available over the counter, are sometimes used to manage TED. Selenium is an antioxidant mineral that helps protect your cells and immune system, particularly the thyroid gland.
Check with a health care professional before starting any new supplements.
Orbital radiotherapy — which involves the use of targeted radiation to treat the tissues and muscles around the eyes — can help to reduce the swelling in the muscles and tissues around your eyes. In addition to helping with inflammation, it can help reduce double vision. The use of orbital radiation has declined in recent years due to the availability of alternative treatment options such as teprotumumab.
If you have trouble shutting your eyes because your eyelids won’t move all the way up or down, your doctor might recommend orbital and/or eyelid surgery. When your eyelids are too tight and can’t close, there may be damage to the cornea, the normally clear front surface of the eye. Surgery can help remedy this problem.
You may benefit from eye muscle surgery. This procedure is meant to help you move your eye muscles better and correct diplopia (double vision).
Lastly, your health care provider might recommend orbital decompression surgery, which relieves pressure on your optic nerve and lessens your eye bulge. This is done by making your eye socket larger and/or removing excess tissue. This surgery is usually performed before eyelid or eye muscle surgery.
On TEDhealthteam, the social network for people living with thyroid eye disease and their loved ones, members ask questions, give advice, and share their stories with those who understand life with TED.
Have you found effective ways to reduce eye pain related to TED? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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Paul B. Griggs, M.D.
is certified by the American Board of Ophthalmology.
Learn more about him here.
Anika Brahmbhatt
is an undergraduate student at Boston University, where she is pursuing a dual degree in media science and psychology.
Learn more about her here.
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