Thyroid hormones are essential for normal body function and are produced by thyroid gland, which is located in the neck. Patients with thyroid dysfunction can have one or more of the following symptoms:

·         Tiredness

·         Palpitations

·         Tremor

·         Intolerance to heat

·         Sweating

·         Increase in appetite

·         Loss of weight

·         Anxiety, nervousness and bad temper

·         Neck swelling due to enlargement of thyroid gland (goiter)

Thyroid eye disease is an eye condition related to thyroid disease which tends to affect   middle aged women more commonly.

Thyroid eye disease affects 25-50% of patients of graves disease.

Symptoms of thyroid eye disease (TED)

Patients may complain of the following:

·         Staring appearance

·         Tearing

·         Gritty sensation in the eye

·         Protrusion of the eye

·         Redness of eye

·         Puffiness of the eyelids

·         Double vision

·         Blurred vision

·         squint

             Fig 1 – shows thyroid eye disease                            

             Fig 2 – shows lid retraction before operation          

Fig 3 – Post operative picture of the same patient in figure 2 

Complications of TED

·         The most important, but fortunately rare complication is the loss of vision due to the compression of the optic nerve by the swollen tissue surrounding the optic nerve.

·         Glaucoma (raised pressure within the eye).

·         Exposure of the front surface of the eye (due to inability to completely close the eyelids) leading to corneal ulcer.

·         Double vision.

Treatment

·         Tear substitutes and lubricants help to protect the surface of the eye from drying. Taping the eyelids shut at night is also useful.

·         Special prism lenses may relieve double vision.

·         Steroids are used in selected cases, especially if the vision is threatened.

·         Radiation is an effective way of reducing tissue swelling around the eye and relieving compression of the optic nerve. The dose used is very low and thus very safe.

·         An abnormal staring appearance

·         Severe protrusion of the eye

·         Disturbing double vision not relieved by prism glasses

·         Drooping or sagging of tissue around the eyes

Thyroid eye disease should be treated by ophthalmic surgeons who specialize in conditions affecting the eyelids and socket.