Thyroid Eye Disease Treatment Options

Early Thyroid Eye Disease treatment can help prevent serious eye damage

Thyroid Eye Disease (TED) is a serious, vision-threatening condition that can get worse over time, if left untreated. The longer that TED goes untreated, the more likely it is for serious damage to happen to your eyes. The earlier you start treatment for your Thyroid Eye Disease, the better. Read on to learn about your TED treatment options.

Common Thyroid Eye Disease treatments

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Eye drops/gel

Eye drops or gel

Over-the-counter eye drops may help provide relief for dry, gritty eyes. In some cases, doctors will prescribe a specific type of eye drops to use.

For retracted eyelids, or eyelids that can’t close, a lubricating gel can be used to prevent the eye from getting dry while you sleep.

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Steroids

Steroids are one of the most common treatments and can potentially provide some symptom relief. People with TED usually start on a higher dose which is slowly lowered. This is done to help avoid the long-term negative effects of steroid usage, such as weight gain and increased risk of infections.

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Radiotherapy

Orbital radiotherapy (ORT) is another approach used to treat TED. This treatment aims beams of energy (radiation) at a precise point on the body. In the case of TED, the area targeted is behind the eye. ORT may provide some symptom relief for some people with TED.

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Surgery

When TED reaches the “chronic” phase, surgery is sometimes used to correct damage that resulted from scarring.

It usually takes multiple surgeries to correct the issues caused by TED. These surgeries are often done in a specific order.

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A different treatment option

Today, a treatment option that works differently is available.

Learn more

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Nurse Advocates do not provide individual patient care or medical advice. After speaking with a Nurse Advocate, be sure to talk to your doctor about your condition and treatment options.

Thyroid Eye Disease surgeries

Once Thyroid Eye Disease (TED) reaches the chronic phase, surgery is sometimes used to correct serious damage caused by scarring.

Surgery may help correct a number of TED symptoms, including bulging eyes, double vision, retracted eyelids, misaligned eyes and other changes to your appearance and vision. While some people with TED may achieve the desired results with the first surgery, multiple surgeries are usually needed—sometimes as many as 4 or more.

TED surgeries are often performed by an oculoplastic surgeon or strabismus surgeon. These surgeons are eye doctors who specialize in surgery of the eye.

Because TED surgeries are complex, they usually take place in a very specific order.

Orbital Decompression Surgery

The goals of orbital decompression surgery:

  • Improve the eyelid’s ability to close over the eye, which means that the eye will be better protected
  • Reduce the appearance of eye bulging
  • Relieve eye pain
  • Release pressure on the optic nerve, which can restore and/or improve vision
  • Potentially improve double vision, but correcting double vision will often require a follow-up surgery called strabismus (strah-biz-muss) surgery

What are the steps involved?

  • The surgeon will remove, shave, or sculpt a section of bone from behind the eye to help the eye move back into its socket
  • The surgeon may also remove some fat from behind the eye, which can harden because of inflammation
  • Room is made behind the eye for the enlarged muscles that developed with the disease
  • This surgery can be done endoscopically, meaning a small cut is made above the eye or through the nose

Double Vision (Strabismus) Surgery

The goals of double vision surgery:

  • Correct double vision that may remain after orbital decompression surgery
  • Helps people with TED to have better straight-ahead vision needed for daily activities like driving or reading
  • This surgery may eliminate the need to wear prisms, which are corrective glasses that help with double vision

What are the steps involved?

  • During double vision surgery, the surgeon “manipulates” or moves the muscles around the eye to get the eyes to point in the same direction
  • In about 5-10% of cases, more than 1 surgery is needed to achieve good muscle placement

Eyelid repositioning surgery

The goals of eyelid repositioning surgery:

  • Return the eyelids to a more normal position
  • Restore appearance
  • Reduce dry eye

What are the steps involved?

  • During eyelid repositioning surgery, the surgeon releases the muscles and tendons around the eyelid, allowing the eyelids to return to a more natural position
  • A common phrase associated with this surgery is that the “eyelids are lengthened”

Face sculpting

The goal of face sculpting surgery:

  • Restore appearance of the eyes and face

What are the steps involved?

  • The swollen and puffy tissue around the eye can be treated with sculpting surgery such as blepharoplasty (blef-ah-roe-plas-tee), also called an eye lift, or facelift surgery
  • The aged appearance of the skin can be treated with laser resurfacing and injections

Doctors recommend that patients wait 2-4 months between each surgery. Depending on how many surgeries are required, the surgical process for TED can last anywhere between 2-16 months.

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Treating TED early can help prevent serious eye damage.

Learn about a different treatment option for TED.

Real TED patient. Real TED story.

Watch what a patient living with TED had to say about his surgery experience.

Video preview of TEPEZZA patient, Ron

“To save my vision, and prevent me from going completely blind, they had to perform fairly immediate surgery. And they did the first of 6 surgeries.” - Ron, real TED patient