Thyroid eye disease (TED) is a chronic autoimmune disorder that causes inflammation in the muscles and tissues behind the eye. This condition can lead to other eye complications, including glaucoma.

Understanding Thyroid Eye Disease (TED)

Thyroid eye disease, sometimes called Graves’ eye disease, affects about 1 in 3 people with Graves’ disease. However, TED can also develop in individuals with other thyroid disorders or even in those with normal thyroid function.

Common symptoms of TED include:

• Dry, gritty, or irritated eyes
• Red or watery eyes
• Puffy eyelids
• Bulging eyes (proptosis), making it difficult to close the eyelids
• Sensitivity to light
• Double vision

As TED progresses, it can lead to severe complications like corneal ulcers or vision loss.

Can Thyroid Eye Disease Cause Glaucoma?

Glaucoma is a group of eye conditions that result in optic nerve damage, leading to vision loss and blindness. Changes in eye pressure due to TED can impact eye health, increasing the risk of glaucoma.

The Link Between TED and Glaucoma

• A 2024 NIH study found that 29% of people with TED had glaucoma, compared to 6% of those without TED.
• After adjusting for confounding factors, researchers concluded that people with TED are 3.3 times more likely to develop glaucoma.
• Another 2024 study showed that people with both glaucoma and TED had worse optic nerve damage and faster disease progression than those with only glaucoma.

How Can You Prevent Thyroid Eye Disease and Glaucoma?

While the exact causes of TED aren’t fully understood, certain preventive measures can help reduce the risk.

Preventing Thyroid Eye Disease

• Early thyroid management: Properly treating thyroid dysfunction can help lower TED risk.
• Quit smoking: Smoking increases TED risk by 7 to 8 times.
• Avoid radioactive iodine therapy if you have Graves’ disease and existing eye problems. Discuss alternative treatments with your doctor.

Preventing Glaucoma

• Regular eye exams: Early detection can prevent severe damage.
• Monitor TED symptoms: Increased pressure from TED may lead to glaucoma.
• Follow an ophthalmologist’s advice for eye pressure control and optic nerve health.

Can an Ophthalmologist Detect Thyroid Eye Disease?

Yes, an ophthalmologist can usually diagnose TED through a clinical eye exam. Key signs include:

• Pain during eye movement
• Redness of the eyelids or conjunctiva
• Reduced vision clarity
• Eye bulging (proptosis)

In some cases, imaging tests (CT or MRI) may be needed to assess disease severity.

Managing Thyroid Eye Disease

TED typically remains active for 6 months to 5 years before inflammation subsides. However, treatment is crucial to prevent long-term complications.

Treatment Options for TED

Lifestyle Interventions

• Stop smoking to prevent worsening TED symptoms.
• Wear sunglasses to protect sensitive eyes.
• Use specialized glasses to manage double vision.
• Elevate your head while sleeping to reduce swelling.

Long-Term Outlook

Most TED cases can be managed with eye drops and lifestyle changes. However, some individuals may require medications or surgery for symptom relief.

• Symptoms usually improve after the active phase (average 2 years).
• About 20% of people with TED need surgical intervention.
• Regular eye exams help detect complications like glaucoma early.

Key Takeaway

Thyroid eye disease can lead to serious complications, including glaucoma. While glaucoma cannot be entirely prevented, managing TED effectively can reduce its impact on eye health.

People at risk for TED, such as those with Graves’ disease, should schedule regular eye check-ups. If you experience vision changes, consult an ophthalmologist to protect your long-term eye health.