Table of Contents

Living with thyroid eye disease: Treatment options explained

At Clarity Eye Surgeons in Canberra, our team of highly qualified ophthalmologists has extensive experience diagnosing and treating thyroid eye disease (TED). Combining advanced medical knowledge, 10 years of surgical expertise, and a patient-centred approach, Dr Parth Shah delivers comprehensive care for individuals affected by this complex condition.

Our specialists are recognised for their skill, ensuring accurate assessment, personalised treatment planning, and long-term visual protection. We are dedicated to restoring not only eye health but also confidence and comfort for every patient living with thyroid-related eye changes.

What is thyroid eye disease and how does it affect your eyes and vision?

Thyroid eye disease (TED)—also known as Graves’ orbitopathy or thyroid-associated ophthalmopathy—is an autoimmune condition where the immune system mistakenly attacks the tissues around the eyes. This leads to inflammation, swelling, and tissue remodelling behind the eye.

The disease often develops in people with an overactive thyroid (hyperthyroidism) due to Graves’ disease, but it can also occur in those with normal or low thyroid function.

Common symptoms include:

Eye bulging or prominence. (proptosis)
Redness, swelling, or puffiness around the eyes.
Grittiness or dryness.
Double vision. (diplopia)
Difficulty closing the eyes.
Pain or pressure behind the eyes.
Sensitivity to light.

In severe cases, TED can lead to compression of the optic nerve, causing blurred or reduced vision. Early detection and proper management are vital to prevent long-term visual damage.

What causes thyroid eye disease to develop?

Thyroid eye disease is caused by an abnormal autoimmune response. The immune system produces antibodies that target the tissues surrounding the eyes—especially the muscles and fat within the eye socket (orbit).

Several factors can increase the risk of developing or worsening TED:

Uncontrolled thyroid hormone levels. (hyperthyroidism or hypothyroidism)
Smoking, which greatly increases disease severity and risk of progression.
Family history of autoimmune thyroid disorders.
Gender and age, as the condition is more common in middle-aged women.
Radioactive iodine therapy, which can sometimes trigger or worsen TED in certain patients.

How is thyroid eye disease diagnosed?

At Clarity Eye Surgeons in Canberra, our diagnosis process involves a comprehensive eye assessment to evaluate disease activity, eye movement, and visual function.

Diagnostic steps may include:

Detailed eye examination: Assessing eye movement, eyelid position, corneal health, and optic nerve function.
Thyroid function tests: Measuring levels of thyroid hormones (T3, T4, TSH) and antibodies to determine underlying thyroid imbalance.
Imaging tests: MRI or CT scans of the orbits help visualise inflammation, muscle enlargement, and pressure on the optic nerve.

Accurate diagnosis helps us determine whether the disease is in its active (inflammatory) or inactive (stable) phase, which is crucial for choosing the right treatment.

What are the treatment options for thyroid eye disease?

Treatment for thyroid eye disease is tailored to the stage, severity, and symptoms of the condition. The goal is to control inflammation, relieve discomfort, and protect vision.

1. Medical management for mild cases

In the early or mild stage, management may include:

Lubricating eye drops and gels to relieve dryness and irritation.
Cold compresses to reduce swelling and redness.
Sleeping with head elevated to minimise overnight puffiness.
Smoking cessation, as quitting smoking significantly improves treatment outcomes.
Thyroid hormone control under guidance from an endocrinologist.

2. Corticosteroid therapy

For active inflammation, steroid treatment (oral or intravenous) can effectively reduce swelling and discomfort. This helps protect the optic nerve and prevent further tissue damage.

3. Immunosuppressive and targeted biological therapy

For patients with moderate to severe TED, newer biological agents can help modulate the immune response:

Teprotumumab, an FDA-approved targeted therapy, helps reduce inflammation and eye bulging.
Rituximab or mycophenolate mofetil may be considered for specific immune-mediated cases.

These treatments are used under specialist supervision, ensuring safety and effectiveness.

4. Orbital radiotherapy

Low-dose orbital radiotherapy can help control inflammation and reduce muscle swelling in selected patients. It is often combined with corticosteroids for improved results.

5. Surgical treatment for inactive or stable disease

Once the active inflammation subsides, surgery may be considered to correct residual effects such as eye bulging, eyelid retraction, or double vision.

Common surgical options include:

Orbital decompression surgery – to create more space for the swollen tissues and reduce eye bulging.
Strabismus surgery – to realign the eyes and correct double vision.
Eyelid surgery – to restore natural eyelid position and improve eye protection.

When should you consult an eye specialist for thyroid eye disease?

You should see a specialist ophthalmologist or oculoplastic surgeon if you experience any of the following:

Persistent eye swelling or bulging.
Pain, pressure, or tightness around the eyes.
Double vision or difficulty focusing.
Changes in eye appearance or movement.
Reduced or blurry vision.

Early referral and treatment greatly improve the likelihood of preserving vision and achieving better cosmetic and functional outcomes.

How do Clarity Eye Surgeons manage thyroid eye disease?

At Clarity Eye Surgeons, we provide a comprehensive and multidisciplinary approach to treating thyroid eye disease. Our ophthalmologists collaborate closely with endocrinologists to stabilise thyroid hormone levels while addressing eye symptoms effectively.

Our approach includes:

Thorough evaluation and imaging to assess orbital inflammation and eye alignment.
Individualised treatment planning, from medical therapy to advanced surgical correction.
Modern surgical techniques for orbital decompression and eyelid repair to enhance both vision and appearance.
Long-term follow-up care to monitor disease stability and prevent recurrence.

Our mission is to help patients restore eye comfort, function, and confidence through safe, evidence-based care.

Can thyroid eye disease be cured completely?

While thyroid eye disease cannot always be completely cured, it can be effectively controlled and its impact reduced. Once the disease becomes inactive, symptoms often stabilise or improve with appropriate medical and surgical treatment.

With expert care, most patients experience significant improvement in both visual function and cosmetic appearance, allowing them to return to daily life with comfort and confidence.

Conclusion

Living with thyroid eye disease can be physically and emotionally challenging, but you do not have to face it alone. At Clarity Eye Surgeons, we combine clinical excellence, compassion, and modern technology to deliver the best outcomes for our patients.

If you are experiencing symptoms of thyroid eye disease, early evaluation is key. Contact Clarity Eye Surgeons today to schedule a consultation and take the first step towards protecting your vision and restoring your quality of life.

Author bio

Dr Parth Shah is a director and principal ophthalmologist at Clarity Eye Surgeons in Canberra. With extensive training and experience, he is renowned for his expertise in the field. Dr Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He is a true advocate for eye health and a trusted name in the Canberra ophthalmology community.

FAQs

How long does thyroid eye disease usually last?

Thyroid eye disease typically has an active phase lasting between six months and two years. During this period, inflammation and changes in the eye tissues occur. After the active phase, the condition usually becomes stable or inactive, though some effects may remain and can be managed surgically if needed.

Can thyroid eye disease affect only one eye?

Yes. Although TED commonly affects both eyes, it can sometimes appear asymmetrically—where one eye is more affected than the other, or occasionally, only one eye shows symptoms. This makes regular specialist monitoring crucial for accurate assessment.

Does stress make thyroid eye disease worse?

Stress itself does not directly cause thyroid eye disease, but it can worsen autoimmune activity and thyroid hormone fluctuations. Managing stress through rest, mindfulness, or professional help may help reduce symptom flare-ups and support overall wellbeing.

Can diet or nutrition influence thyroid eye disease?

While diet cannot cure TED, maintaining balanced nutrition supports thyroid function and tissue healing. A diet rich in antioxidants, selenium, and omega-3 fatty acids can be beneficial. It is also advisable to limit salt and alcohol intake to reduce swelling and inflammation.

Is it safe to wear contact lenses with thyroid eye disease?

Contact lens wear can become uncomfortable during the active phase of TED due to dryness or eyelid swelling. Most patients prefer glasses until inflammation settles. Once the condition stabilises, contact lens use may be resumed under the guidance of an eye specialist.

Can thyroid eye disease return after treatment?

Recurrence is uncommon but can happen, especially if thyroid hormone levels become unstable or if the patient resumes smoking. Regular follow-up appointments and maintaining optimal thyroid control help prevent relapse.

What lifestyle changes can help manage thyroid eye disease symptoms?

Simple lifestyle habits can make a difference—stop smoking, protect eyes from wind and sunlight with sunglasses, use lubricating drops, sleep with your head elevated, and maintain consistent thyroid treatment as advised by your endocrinologist.