Graves’ disease and the associated eye changes (thyroid related eye disease – TED) can be frustrating for affected patients. The eye symptoms usually occur around the the same time as the onset of the thyroid dysfunction. Many patients with thyroid abnormalities will only be affected mildly by the eye disease. Approximately 5% of the patients with TED will have severe disease that can cause vision loss and blindness. Although the incidence of eye disease associated with thyroid dysfunction is higher and more severe in smokers, there is no way to predict which patients will be affected. In many cases successful treatment of the thyroid gland does not guarantee that the eye disease will improve no thyroid treatment can guarantee that the eyes will not continue to deteriorate. Once inflamed, the eye disease may remain active from several months to as long as three years. In some cases there may be a gradual mild improvement.
Early eye symptoms, which may include dryness, redness, itching, swelling of the lids and inability to wear contact lenses, are usually mild. Some patients find these symptoms to be particularly irritating at night and under certain conditions such as air conditioning, hot air heating and windy days. A few patients will develop double vision (diplopia), which is the result of asymmetric scarring and inflammation of the muscles that control eye movement. Many patients are often misdiagnosed with an ocular allergy and should be examined and followed by an Oculoplastic/Orbit specialist familiar with the condition and available treatments. There are many treatments available to treat the annoying discomfort caused by TED. These treatments can be custom tailored to your condition by your specialist.