How Is Graves Disease Diagnosed
If you believe you have Graves disease, you should seek medical attention. Healthcare professionals can assess your case based on your symptoms and findings during a physical examination. Approximately one out of every three people with the condition will show signs of Graves ophthalmopathy.
To diagnose the disease, doctors may perform one or multiple blood tests. They may also check for an enlarged thyroid and ask about a family history of thyroid or autoimmune problems.
If clinical doubts remain, doctors may follow up with further blood tests or perform imaging scans like magnetic resonance imaging . These imaging tests may use small yet safe doses of radioactive iodine to see iodine uptake by the thyroid.
Fact: The Sooner Ted Is Treated The Better Ted May Cause Serious Eye Damage
Thyroid Eye Disease is an ongoing condition with 2 phases. If left untreated, TED may get worse over time.
Phase 1: Acute TED During the acute phase, symptoms appear suddenly and can get worse quickly. Inflammation and scarring can start to damage your eyes. Because of this damage, you may notice symptoms like eye pain, redness, swelling, eye bulging, double vision, and misaligned eyes. The acute phase usually lasts between 6 months to 3 years.
Phase 2: Chronic TED Over time, TED changes to the chronic phase where scarring and damage continue. During this phase, some symptoms may get betterlike redness and swelling. But others may not go awaylike eye bulging, double vision, misaligned eyes and eye pain. If left untreated, some symptoms may return, or flare up.
Spot TED symptoms, avoid serious damage
Keeping track of your symptomsand talking with your doctor right away about any changescan have a big impact. Speak up for the care you deserve.
Symptoms Of Thyroid Eye Disease
Early symptoms of thyroid eye disease may include:
- Itching, dry eyes, and difficulty wearing contact lenses
- Excessively watery eyes
- Red or bloodshot eyes
- Swelling of the orbital tissues which causes the eye to be pushed forward referred to as exophthalmos, which can make people with thyroid eye disease appear to have a wide-eyed or bulging, protuberant stare.
- Pain when moving the eyes up, down, or sideways
- Light sensitivity
Thyroid eye disease can cause inflammation and swelling that may affect the eyes as well as the muscles and other tissues around the eyes. As the disease progresses, symptoms can include the following:
- Increased sensitivity to light
- Impaired vision
- Difficulty moving or closing the eyes
Thyroid eye disease is known to go through varying degrees of severity and can go into periods of remission. It often lasts six months to two years. When it has been inactive for a period of around a half a year, it’s less likely to recur.
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Why Aren’t There Any Ratings
There is no publicly available rating for this care provider for one of three reasons:
- Ophthalmology, Oculofacial Plastic Surgery and Ophthalmology Portland
Fact: Thyroid Conditions And Ted Need To Be Treated By Different Doctors You Should See An Endocrinologist For Graves Disease Or Other Thyroid Conditions And A Ted Specialist For Ted
Graves disease and Thyroid Eye Disease affect different parts of the body. Graves disease affects the thyroid and should be managed by an endocrinologist, who is an expert in treating thyroid issues.
TED is a separate disease that affects the eyes and should be managed by a doctor experienced in treating it: a TED Specialist. There are a few different types of eye doctors who can be TED Specialists.
If you have both conditions, your endocrinologist and your TED Specialist should stay in regular contact with each other. They need to work together to make the best treatment plan for you.
If you suspect you may have Thyroid Eye Disease, see a TED Specialist and ask for a baseline eye exam.
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Radioactive Iodine Uptake And Thyroid Scan
A radioactive iodine uptake test measures the function of the thyroid gland. A small amount of radioactive iodine is given in a pill that is swallowed. The iodine collects on the thyroid. After some time, a special probe is used to scan the thyroid and measure the amount of iodine taken up by the thyroid.6,8
The RAIU is often used with a thyroid scan, which uses a special camera to view the size, shape, and position of the thyroid.6
What Are The Symptoms Of Thyroid Eye Disease
Symptoms of thyroid eye disease can start before, during, or after your doctor diagnoses you with Graves’ disease.
Eye symptoms don’t have anything to do with how severe your hyperthyroidism is. You can have very severe hyperthyroidism and mild eye symptoms, or vice versa. It’s possible to have eye symptoms even if your thyroid gland isn’t overactive.
Besides swollen and bulging eyes, symptoms may include:
- A feeling of grittiness or irritation in your eyes
- Redness of the white part of your eye
- Pain when you move your eyes
- Tearing or dry eye
- Eyelid swelling
Symptoms like these might make you worry that you’ll lose your vision. But it’s very rare for people with thyroid eye disease to have permanent vision loss.
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What Are The Symptoms Of Graves Disease
The symptoms of Graves disease may include:
- anxiety or irritability
- tremors and/or a racing heart
- feeling hot and/or sweating
- diarrhoea and/or weight loss
- infrequent menstrual bleeding or infertility
About 2 in every 5 people with Graves’ disease develop bulging eyes . This is because the antibodies that attack the thyroid can also attack the muscles and tissues around your eyes. This is called thyroid eye disease .
If you have Graves disease, you may also develop a goitre, which is a swollen thyroid gland that is visible to others.
If youre pregnant and have poorly controlled Graves disease, you may have an increased risk of complications, such as miscarriage and premature birth.
How Is Graves’ Disease Treated
The treatment of hyperthyroidism is described in detail in the Hyperthyroidism brochure. All hyperthyroid patients should be initially treated with beta-blockers. Treatment options to control Graves disease hyperthyroidism include antithyroid drugs , radioactive iodine and surgery.
Antithyroid medications are typically preferred in patients who have a high likelihood of remission . These medications do not cure Graves hyperthyroidism, but when given in adequate doses are effective in controlling the hyperthyroidism.
If methimazole is chosen, it can be continued for 12-18 months and then discontinued if TSH and TRAb levels are normal at that time. If TRAb levels remain elevated, the chances of remission are much lower and prolonging treatment with antithyroid drugs is safe and may increase chances of remission. Long term treatment of hyperthyroidism with antithyroid drugs may be considered in selected cases.
If your hyperthyroidism due to Graves disease persists after 6 months, then your doctor may recommend definitive treatment with either radioactive iodine or surgery.
If surgery is selected as the treatment modality, the surgery should be performed by a skilled surgeon with expertise in thyroid surgery to reduce the risk of complications.
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How Can I Find Support
Because thyroid eye disease can change your vision and appearance, it can have a big effect on your life. It’s important to get support along with your treatment. You might start by talking to family and friends about what youâre going through.
Depression is common in people with thyroid eye disease. If you feel like youâre struggling, talk to your doctor. They can put you in touch with a mental health professional who can help.
Graves’ disease support groups are another place to turn. You’ll meet other people with thyroid eye disease who may have advice to help you manage your condition. You can find a support group through an organization like the Graves’ Disease & Thyroid Foundation.
Treatment Of Thyroid Eye Disease
For a mild case, use lubricating eye drops and artificial tears a few times during the day. Avoid wind and bright light.
If you have severe symptoms, your healthcare provider may prescribe corticosteroids such as prednisone to reduce swelling. In a very small percentage of patients, orbital decompression surgery may be recommended.
This procedure removes the bone between the eye socket and the air sinus behind it so your eye has more room. This can improve your vision but there is a risk of double vision.
Double vision can also occur when scar tissue from the ophthalmopathy makes an eye muscle too short. Eye muscle surgery can be used to attach the muscle at a point where it will again be the correct length to provide single vision. However, more than one surgery may be needed to be successful.
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Thyroid Eye Disease Can Cause Tissue Damage Know Its Symptoms And Ways To Avoid It
Thyroid Eye can cause swelling in the eyes.
During this problem, eye tissue damage can occur.
Vision problems can also occur due to thyroid eye.
Symptoms Of Thyroid Eye: Thyroid eye disease is a type of eye related problem which is caused by inflammation and damage of muscles, fatty tissue and connective tissue. Thyroid eye disease ie TED is related to Grebs disease which is an autoimmune condition. Which can have an effect on the skin and eyes. Generally, this problem occurs in two phases, the active phase which can disturb for months, while the second inflammatory phase means as long as there is swelling, this problem can remain in the eyes. Graves disease can later lead to hyperthyroidism.
People who have thyroid eye problems may have to face many problems. If its symptoms are recognized in time, then its proper treatment can be done. Let us know about its symptoms.
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How does thyroid eye affectThe problem of thyroid eye is more in women than in men. according to the cleveland clinic When the problem of thyroid takes a serious form, then problems related to the eyes can increase. The bodys immune system starts attacking the muscles and tissues around the eye, due to which thyroid hormones are produced in excess or less than required. Which can affect the eyes.
Symptoms of Thyroid Eye less visiblePain in moving the eyes
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Does Diet Affect Thyroid Eye Disease
People with Graves disease may want to stay away from eating foods with large amounts of iodinesuch as kelp, dulse, or other kinds of seaweedthat may cause or worsen hyperthyroidism. Taking iodine supplements can have the same effect. Avoid biotin supplements as they can interfere with your thyroid blood tests.
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Fact: Ted Is A Different Condition From Graves Disease
Many people think Graves disease and Thyroid Eye Disease are the same. Thats because people often have both diseases at the same time.
That is also because both are autoimmune diseases. This means your bodys immune system attacks a healthy part of your body by mistake.
If you have Graves disease, your bodys immune system attacks the thyroid. If you have TED, your bodys immune system attacks the tissue behind your eyes. This can cause a number of different changes to your eyes.
TED is often called by different names containing the word Graves or thyroid, including:
- Graves eye disease
Thyroid Glands Relation To The Eye
Although Graves’ disease and Graves’ eye disease both stem from the immune systems attack on healthy tissue, one disease does not directly cause the other. Thats why treatment of the thyroid gland, while important, does not improve the eye disease. The two diseases run their separate courses and do not necessarily occur at the same time.
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How Common Is Thyroid Eye Disease
About one in four patients with Graves disease will have thyroid eye disease. It does not occur with other causes of an overactive thyroid .
Thyroid eye disease is almost five times more common in women than men. However, the disease is often more severe in men. In 90% of people it is associated with an overactive gland, in which case it may be diagnosed before, after, or at the time of diagnosis of Graves disease. In 5% of people it is associated with an underactive thyroid gland and 5% of people affected do not have any thyroid problems. Thyroid eye disease is seven times more likely to occur in smokers.
Thyroid Function And Hyperthyroidism
Before we examine the symptoms and potential causes of Gravesâ eye disease, itâs important to go over the basics of thyroid function.
The thyroid is a butterfly-shaped endocrine gland found in the lower portion of the front of the neck. Its job is to make hormones, secreted in the blood, to perform a variety of metabolic purposes. It helps the body:
- Dry eye and irritation
More progressive swelling may result in:
- Increased pressure in the eye socket
- Pressure pain/deep headaches that worsen with eye movements.
- Eyes pushed forward in the socketâbulging or âstaringâ appearance
- Restricted natural eye movement, resulting in double vision.
While a common fear, blindness is extremely rare among patients with Gravesâ eye disease.
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What Causes Graves Ophthalmopathy
In many cases, Graves disease is responsible for the development of Graves ophthalmopathy. Graves disease is an autoimmune disease in which the body overproduces thyroid hormones, and the immune system responds negatively.
Because thyroid hormones play a vital role in various body systems, the disease severity of Graves ophthalmopathy can differ significantly.
Additionally, Hashimotos thyroiditis may result in Graves ophthalmopathy. This disease, also known as chronic lymphocytic thyroiditis, is the most frequent cause of hypothyroidismin the United States.
The 2009 Amsterdam Declaration signed by more than 80 organizations suggested that incidence and morbidity caused by Graves ophthalmopathy could go down significantly via preventive measures.
These steps included identifying early warning signs, stopping smoking, facilitating earlier access to specialist care, and avoiding hypothyroidism after radioactive iodine administration.
Who Is At Risk For Thyroid Eye Disease
Thyroid eye disease is most commonly associated with Graves disease. It can also occur with normal thyroid hormone levels or low levels of thyroid hormones .
Other risk factors for thyroid eye disease include:
- Age: Usually affects middle-age adults but can occur at any age
- Gender: Females are affected more than males
- Family history of thyroid eye disease
- Smoking: Smoking increases the risk of thyroid eye disease by 78 times, causes thyroid eye disease to have a longer active phase, and it reduces the effectiveness of treatments
- Radioactive iodine therapy: Radioactive iodine has been used to treat hyperthyroidism and Graves disease. This treatment should be used with caution in people with active thyroid eye disease as it may worsen the condition unless steroids are given at the same time
- Low blood levels of selenium, a dietary mineral.
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How To Treat Graves Eye Disease
If you have this condition, treatments are available. However, treatment plans will depend on disease severity and individual cases.
Your doctor may prescribe the use of corticosteroid medication, immunosuppressants, radiation therapy, thyroid surgery, or eye surgery. To provide pain relief from symptoms, your doctor may also recommend medicated eye drops and non-steroidal anti-inflammatory drugs like aspirin, naproxen, or ibuprofen.
Finally, if you develop Graves orbitopathy, your doctor may prescribe glucocorticoids as first-line treatment. However, this medication does have strong side effects.
Also, the novel drug teprotumumab may be an option considered by your eye care specialist. This medication could manage the ocular condition.
Clinicians may recommend simple yet effective medical management strategies, including smoking cessation or selenium supplement use, to decrease disease severity.
When Is It An Emergency
Most people donât have serious problems from thyroid eye disease. But some symptoms can threaten your eyesight. Itâs rare, but you could get optic neuropathy. Thatâs when the muscles around your eye put pressure on your optic nerve — the nerve that goes from your eye to your brain.
Get medical help right away if you have:
- Serious eye pain
- Sudden or patchy vision loss
- Problems with peripheral vision
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How Quickly Does Thyroid Eye Disease Progress
The active phase can last anywhere from approximately 6 months to 2 years. This is followed by an inactive phase in which the disease progression has stopped. However, some symptoms such as double vision and bulging eyes can remain. In some people, cosmetic changes and significant disability can develop.
When To See A Healthcare Provider Or Go To The Hospital
If you have symptoms that could indicate thyroid eye disease, you should talk to a medical professional as soon as possible. Early diagnosis can lead to faster treatments that may help you avoid some of the potential complications of the disease.
Even if you have already received a thyroid eye disease diagnosis, you should notify your healthcare provider of any changes in symptoms. It is important to keep monitoring your condition, so your practitioner can adjust treatments.
In general, you should notify your healthcare provider if you notice any changes in the appearance of your eyes or have problems seeing.
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Can Lack Of Sleep Cause Thyroid Problems
Sleep habits may play a role in your susceptibility to thyroid disease. One study9 found that people who sleep fewer than seven hours per day are at greater risk of developing hyperthyroidism, while sleeping more than eight hours per day may increase the risk of both overactive and underactive thyroid function.