Thyroid eye disease can occur when tissue behind the eye becomes inflamed. Treatment options depend on the cause but typically include artificial tear drops, selenium supplements, and steroids.
Thyroid eye disease (TED) is an autoimmune condition that is common in people with Graves’ disease.
Symptoms typically include irritation, inflammation, and discoloration in the eye area. In more severe cases, people experience bulging, retraction of the eyelids, and pressure on the optic nerve.
Treatments can include:
- home remedies
- medications
- surgeries
Some treatments address the TED itself, while others treat the underlying Graves’ disease.
There is ongoing research into better treatment options. Keep reading to find out the latest in TED management.
IV infusions
Teprotumumab-trbw (Tepezza) is an antibody medication developed to relieve swelling in cases of TED. It eases the pressure on your optic nerve and reduces bulging of the eyes.
According to the
Teprotumumab-trbw is an infused medication. This means it’s delivered through an intravenous (IV) needle in your arm. Treatment involves 8 IV infusions.
Each infusion will be
As with any medication, there can be side effects. Common side effects of teprotumumab-trbw include:
- fatigue
- muscle cramps
- nausea
- diarrhea
- headaches
Antithyroid drugs
Graves’ disease is an autoimmune disease that attacks the thyroid. When under attack, your thyroid releases too much thyroid hormone. This is called hyperthyroidism.
Antithyroid drugs stop your thyroid from producing hormones. The goal is to bring thyroid levels to a healthy target.
Although TED often occurs with Graves’ disease, they are separate conditions. TED can still occur with low or healthy thyroid levels. The conditions will run their own courses.
If your thyroid levels are too high or low, a healthcare professional will closely monitor your blood levels. This helps them determine whether treatment is working or needs to be adjusted.
There are several home remedies that may help relieve your symptoms during the active phase of TED. These include:
- eye drops to lubricate the eye
- cool compresses
- wearing sunglasses for light sensitivity
- wearing glasses with a prism for double vision (your eye specialist may recommend this)
Synthetic hormones
When the thyroid is removed, levels can drop too low, according to 2016 guidelines by the American Thyroid Association (ATA) and you will be started on synthetic thyroid hormone.
In the case of low thyroid levels due to antithyroid drugs, a doctor will reduce your dose of the medication.
Selenium supplements
Selenium is an antioxidant taken as an oral supplement. A doctor can advise you on whether selenium might help your condition.
Botulinum toxin A
A healthcare professional may suggest injecting botulinum toxin A (BTA) into your eye muscles to treat strabismus. This is when your eyes don’t correctly align with each other when you look at an object.
BTA can also be injected into the eyelid to improve its shape and position.
Injectable therapies are not permanent, so they can be used in active or inactive TED.
Radioiodine
Radioiodine, a type of radiation treatment, has been used in treating Graves’ disease. However, a 2021 review suggests that it can worsen thyroid eye disease. According to the ATA guidelines, surgery or antithyroid medications are best in cases of moderate to severe TED.
Radiation therapy should be avoided, especially in people who are pregnant and those who smoke.
Thyroidectomy
There’s mixed evidence about the best way to treat Graves’ disease if you have active TED.
Surgery to remove all of your thyroid results in almost no chance of recurrence of Graves’ disease. However, this treatment is not suitable for everyone. Speaking with a doctor can help you determine the best treatment options for your individual needs.
Eye surgery
Depending on the severity of TED, surgeries may be part of the treatment plan. These include:
- orbital decompression, to remove of bones from the eye socket
- strabismus (eye muscle) surgery, to correct eye misalignment
- eyelid retraction surgery, to move the eyelid back into the correct position
These surgeries are used to manage symptoms and restore the function and appearance of the eye.
Thyroid eye disease is an autoimmune condition common in people with Graves’ disease. It can occur when tissue behind the eye becomes inflamed. Treatment options depend on the cause but typically include artificial tear drops, steroids, and in severe cases, surgery.
There have been many advances in surgeries and medications for TED, with better outcomes and less invasive approaches.
If you have TED, consider speaking with a doctor about the best options for treating the condition.