Hay fever, allergies, and inflammation of the conjunctiva (conjunctivitis) can also cause symptoms similar to those seen in mild thyroid eye disease.
Orbital myositis can often mimic the clinical appearance of thyroid ophthalmopathy. This condition is most often unilateral, and the tendinous insertions of the extraocular muscles are also enlarged.
Smith added that because the typical symptoms of thyroid eye disease mirror so many other eye conditions, it can often be mistaken as allergies or conjunctivitis. These misdiagnoses only lead to a further delay in appropriate treatment.
Diagnosis and Tests
If your healthcare provider thinks that you have thyroid eye disease, they'll order blood tests to check if your thyroid hormone levels and antibodies are too high or too low. Other tests your provider may request include: Ultrasound of the eyes. Computed tomography (CT).
People need to know that thyroid eye disease can occur “at any time, in anyone, whether they have thyroid disease or not,” she says.
To diagnose thyroid eye disease, you will need a complete eye exam, lab tests, and imaging tests. The ophthalmologist will test your vision, color vision, and visual fields. In addition, eyelid measurements will be taken, eye pressure tested, and optic nerve checked.
Retraction of the eyelid (Figure 1) is the most common clinical sign, present in 90% of patients with thyroid eye disease. Exophthalmos (60% of patients) and restricted eye movement (40% of patients) are also common.
blurred or double vision. red eyes. red, swollen or pulled back eyelids. bulging eyes.
Several risk factors have been identified in the development of TED including genetics and family history, sex (women are at a higher risk than men), cigarette smoking, and treatment with radioactive iodine treatment.
TED begins with an acute phase, which means that symptoms appear suddenly and often get worse. The acute phase can last from 6 months to 2 years. The inflammation (redness and swelling) and scarring that start to form during this phase can damage your eyes, and cause a number of changes.
Eye Swelling and Redness
Thyroid eye disease causes lots of inflammation, including in the soft tissue in and around your eyes and eyelids. You might get pain and pressure along with: Redness or bloodshot eyes. Swelling in the white parts of your eye.
Your eye doctor can check for Graves' eye disease by doing a physical eye exam. During the exam, your doctor will take a close look at your eyes and eyelids. If your eye doctor thinks you may have Graves' disease, you'll need blood tests to check if your thyroid is working correctly.
Computed tomography (CT) imaging of the orbit is the standard clinical practice in the diagnosis and management of thyroid eye disease (TED).
FACT: You can develop TED without having Graves' disease.
While it's true that many people are diagnosed with Graves' before being diagnosed with Thyroid Eye Disease (TED), it's not always the case. In fact, about 1 in 10 people with TED develop it without having Graves' disease.
Sensitive Skin and Skin Discoloration
Thyroid hormones also influence the quality of your skin in various ways. For example, with hyperthyroidism, you may notice itchy and dry patches of skin. Your face may feel softer and swollen. You may even notice swelling around your fingertips.
There are two phases. The active phase, marked by inflammation, usually lasts from six months to two years. The focus during this stage is on medical treatment to relieve the eye symptoms. During the second phase, or the stable phase, inflammation and other symptoms have subsided.
Thyroid eye disease in its active phase can last between one and three years. That means if it is left untreated, the inflammation may gradually decrease by itself but may cause damage to vision through the course of the disease.
Eye problems will usually occur and frequently change in type or severity for between six months and two years. Once stabilized, it is unusual for the eyes to start changing again. Some patients are left with permanent changes, and in others the eyes return to normal.
A swollen fingertip, curved nail, and thickening skin above a nail are often signs of thyroid disease.
Age. Graves' disease usually develops in people before age 40. Other autoimmune disorders. People with other disorders of the immune system, such as type 1 diabetes or rheumatoid arthritis, have an increased risk.
Its common symptoms include eye redness, pain and blurred vision. It can affect one or both eyes and can cause vision loss if left untreated by an eye specialist. While the exact cause of autoimmune diseases is unknown, some people are more likely to develop an autoimmune disease than others.
It is due to an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone. Graves disease is most common in women over age 20. But the disorder can occur at any age and can affect men as well.
Neuromyelitis optica is an autoimmune disorder that affects the nerves of the eyes and the central nervous system, which includes the brain and spinal cord. Autoimmune disorders occur when the immune system malfunctions and attacks the body's own tissues and organs.