Thyroid Eye Disease

What is Thyroid Eye Disease?

Thyroid eye disease is a condition that sometimes occurs in patients who have thyroid disease. Different tissues around the eyes, including the muscles, are affected, producing a range of symptoms from “bulging” eyes to vision loss. 

At the Yale Sinus and Allergy Program, in conjunction with colleagues from the Department of Ophthalmology, we help patients with thyroid eye disease regain a more normal-looking eye appearance and help avoid complications that can arise from the disease if left untreated. 

Symptoms of Thyroid Eye Disease

Some symptoms of thyroid eye disease include: 
  • Dry eyes
  • Watery eyes
  • Red eyes
  • Bulging eyes
  • Appearance of a wide-eyed stare
  • Double vision
  • Difficulty closing the eyes
  • Problems with vision
The exact symptoms depend on which eye tissue is affected by the condition. Just because you have one or more of the above symptoms does not mean that you have thyroid eye disease. If you think you have thyroid eye disease, please call your doctor right away, as your vision can be affected.

Causes of Thyroid Eye Disease

Thyroid eye disease is attributed to an autoimmune disorder. The immune system normally protects our bodies from foreign invaders, such as bacteria or viruses, and from abnormal cells, such as cancer. In thyroid eye disease, however, the immune system views the muscles and fatty tissue around the eyes as something foreign and begins to “attack” these tissues. Most commonly, thyroid eye disease is caused by abnormal thyroid hormone levels. However, some patients with the condition show normal hormone levels.

Risk Factors of Thyroid Eye Disease

Anything that increases your chance of getting a disease is called a risk factor. Patients with thyroid disease are at the greatest risk for developing thyroid eye disease due to an abnormal level of thyroid hormones in the blood. These hormones are generally found with specific antibodies, as well, in cases of thyroid eye disease. 

However, thyroid eye disease can also occur when the level of thyroid hormone in the blood is normal or low.  

Having a risk factor does not mean that you will get thyroid eye disease. Not having a risk factor does not exclude you from getting a particular disease. If you think you may be at risk for developing thyroid eye disease, you should talk to your doctor.

Treatment for Thyroid Eye Disease

Your vision is important. Treating thyroid eye disease right away can be crucial in avoiding any complications that can affect normal sight. At the Yale Sinus and Allergy Program, our surgeons are experts in the latest surgical treatment for thyroid eye disease. 

When the muscles in the eyelids tighten due to thyroid eye disease, the whites of the eye around the iris (colored part) show, creating a “surprised” or wide-eyed look. Surgery can help improve this symptom. The procedure is performed through the nostrils with endoscopes and specialized angled and curved instruments. The paranasal sinuses are opened and the thin, bony wall between the orbit and ethmoid sinuses is removed. Incisions are made in the soft tissue envelope, separating the orbital fat and contents from the sinuses. This allows the fat to herniate or bulge into the open sinus cavity and thus relieves the pressure in the orbit. The eye subsequently resumes a more normal position in the orbit, minimizing the proptosis (eye bulging).

In some cases, vision can be impaired with thyroid eye disease. Treatment options in such situations include corticosteroids or other anti-inflammatory medications, radiation, and surgery. A combination of these may be necessary to protect vision. We collaborate with endocrinology and ophthalmology to ensure you receive the most complete treatment possible. 

We understand that undergoing surgery can feel intimidating. We are here to answer all your questions and address all your concerns about your surgery and your condition. It is important to us that you feel comfortable and that you understand what to expect before, during, and after your procedure.