Can Thyroid Eye Disease Cause Blindness? And More FAQs

Thyroid eye disease can cause swelling that compresses or damages one or both optic nerves, which carry signals from your eyes to your brain so you can see. This may cause vision loss or blindness in rare cases.

Optic nerve damage affects about 4–10% of people with thyroid eye disease. Most of those people don’t experience full vision loss, but they may experience other vision changes.

Thyroid eye disease can also cause dry eyes, watery eyes, or changes to your eyelids or the position of your eyes that may affect your vision.

You may experience:

• blurred vision
• double vision
• decreased vision
• reduced peripheral vision
• changes in how you see color or contrast
• increased sensitivity to light

In many cases, these symptoms may improve or resolve on their own within a few years.

Sometimes, you may need prescription eyeglasses, surgery, or other treatments to correct vision changes.

Your doctor may recommend surgery if an optic nerve is compressed, your eyelids are pulling far back from your eyes, or you’re having difficulty moving your eyes.

Optic nerve compression is an eye emergency that requires immediate treatment.

Thyroid eye disease typically gets more severe within the first 6–18 months of the disease, which is known as the initial or active phase. This initial phase may last for longer in some people.

Eye inflammation increases during the initial phase, which may cause your symptoms to get quickly worse. The inflammation can also cause scarring or other lasting changes to tissues in or around your eyes.

Inflammation from thyroid eye disease typically becomes less active after the initial phase of the disease. This may cause many of your symptoms to stabilize, improve, or resolve eventually.

However, some symptoms might continue even after the disease becomes inactive. Inflammation in the active phase can cause lasting tissue damage that remains after the disease becomes inactive.

Getting early treatment is important for limiting the active phase of the disease and preventing lasting damage.

The initial active phase of thyroid eye disease typically lasts 6–18 months, although it may last longer for some people. Your symptoms may get quickly worse during this phase.

Thyroid eye disease often stabilizes on its own within a couple of years, but getting treatment may help slow or stop the progression of the disease more quickly. This is important for limiting lasting damage.

Let your doctor know right away if you notice changes to your eyes, eyelids, or vision.

Multiple treatments are available for thyroid eye disease.

If you have mild thyroid eye disease, your doctor might recommend one or more of the following treatments to manage symptoms:

• lubricating eye drops, gels, or ointments
• injections of corticosteroids or Botulinum toxin A (Botox) to your eyelids, if they’re retracting
• lifestyle changes, such as use of sunglasses or changes to your sleep habits
• selenium supplements

It’s also important to stop smoking or vaping if you participate in those activities. Your doctor can recommend resources to help you cut back and quit. They may refer you to a smoking cessation specialist.

If you have moderate to severe thyroid eye disease, it’s important to get early treatment with medication to reduce the immune response that causes inflammation in your eye. This may help limit symptoms and lasting damage.

Your doctor may prescribe one or more of the following medications to reduce inflammation:

• oral or injected corticosteroids
• immunomodulators, such as:
  • methotrexate
  • azathioprine (Imuran)
  • mycophenolate mofetil (CellCept)
• biologic drugs, such as:
  • teprotumumab (Tepezza)
  • rituximab (Rituxan)
  • tocilizumab (Actemra)
  • adalimumab (Humira)
  • infliximab (Remicade)

Your doctor may also recommend orbital radiotherapy, which uses low dose radiation to reduce inflammation from thyroid eye disease.

Medications and orbital radiotherapy to reduce inflammation are only effective for reducing symptoms during the active phase of the disease. They won’t reduce symptoms after the disease has stabilized and become inactive.

Your doctor may recommend surgery to treat tissue damage in or around your eyes that may cause lasting symptoms, even during the inactive phase of the disease.

They may also recommend prescription eyeglasses to manage certain vision changes.

Talk with your doctor to learn more about your treatment options.

Getting treatment for thyroid eye disease can help limit inflammation during the active phase of the disease. This can help reduce symptoms and may prevent lasting changes to tissues in or around your eye.

After the disease has stabilized, your doctor may recommend surgery to treat certain types of changes or damage to your eyes or eyelids. This may help reverse some of the damage, but it may not reverse the damage entirely. You may have some symptoms that continue after surgery.

Talk with your doctor to learn more about your treatment options and outlook.

Untreated thyroid eye disease may cause more severe damage to your eyes, eyelids, or vision.

Many of your symptoms may eventually improve or resolve, even without treatment. But you may have lasting changes or damage to tissues in or around your eyes that lead to ongoing symptoms.

Early treatment is important for reducing inflammation, limiting symptoms, and preventing lasting damage.

Thyroid eye disease can potentially damage your optic nerves, which may lead to reduced vision or other vision changes. These symptoms may continue even after the disease has stabilized and inflammation is no longer active.

Getting early treatment for thyroid eye disease can help limit inflammation and lasting damage.

Your doctor may prescribe medication and sometimes treatment with low dose radiation to reduce inflammation during the active phase of the disease.

They may recommend surgery if you have damage to your optic nerve or other eye tissues that can’t be treated with medication alone.

They may also recommend lubricating eye drops, nutritional supplements, or other treatments to help manage symptoms and promote eye health. They may advise you to make certain lifestyle changes.

Talk with your doctor to learn more about your treatment options and outlook.