What is it?
It is an inflammatory disease that affects the thyroid gland and the tissue around the eyes, eyelids, the fat and muscles responsible for eye movement. As the immune system changes, it reacts against the thyroid gland and orbit tissues by making them inflamed.
Patients notice a feeling of dryness and redness in their eyes, that they are "bulging" (exophthalmos), double vision depending on where they look (diplopia) or even changes in the usual appearance of their eyelids, be it greater swelling or a greater opening of the eyes (eyelid retraction).
Generally speaking, both eyes are affected, but occasionally it may affect just one eye or be very asymmetric.
Causes and risk factors
It is related to thyroid disease and its activity. The only risk factor that is negatively related to the development of thyroid-associated orbitopathy is smoking.
Different types do not exist but the symptoms manifest themselves differently during the course of the disease.
It may cause exophthalmos, eyelid retraction and swelling and diplopia to a smaller or greater extent in patients affected by this disease.
Thyroid-associated orbitopathy cannot be prevented, but good monitoring of the thyroid function and the appropriate treatment for the symptoms of thyroid-assoicated orbitopathy from its onset provides better control and dvelopment of the disease.
When it comes to thyroid-associated orbitopathy, there are various treatment options depending on the time that has passed and the symptoms shown.
In patients whose symptoms have only recently appeared and who are at the initial stages of the disease (the inflammatory phase), conservative treatment can be provided to protect the cornea from drying due to exposure.
In the event that the disease has progressed with a worsening of the symptoms affecting the vision, treatment with anti-inflamatory drugs (endovenous boluses of cortisone) is provided. The eyes of some patients go back to their normal condition without any sequelae and they do not require surgical treatment.
In patients in the inflammatory phase for various months, the inflammation leads to fibrosis, affecting the muscles and orbital fat. In this phase of fibrosis, surgical treatment is performed through orbital decompression to correct the proptosis. Subsequently, if necessary, the strabismus and palbebral retraction on the upper eyelids can be operated on.
Frequently asked questions
I had thyroid-associated orbitopathy years ago, now I notice that my eyelids are swollen and eyes are red. Could I have the disease again?
As it is an inflammatory disease, it is possible that after some years the disease manifests itself once again. With your history, it is important to see the ophthalmologist so they can perform a full ophthalmic examination. They may possibly ask you to undergo tests like a CT (computerised tomography) or MR (magnetic resonance) scan to evaluate it better.
I have hypothyroidism and I've recently been diagnosed with thyroid-associated orbitopathy. How is it so if I have hypothyroidism?
In the majority of patients, thyroid-associated orbitopathy is associated with hyperthyroidism, although it may happen to some patients, like in your case, who have hypothyroidism and even to people who do not have thyroid disease.