What is Thyroid Eye Disease (TED)?

Eye problems occur relatively commonly with thyroid disease. TED is also known as Thyroid Associated Ophthalmopathy (TAO) or Grave's Ophthalmopathy. In a small proportion of patients (3-5%) it may be require intensive treatment and can be vision threatening.

Bulging red eyes in thyroid eye disease

Who gets TED?

Eye problems are most commonly associated with Grave's disease (up to 50% of patients may have signs if examined carefully), but patients with Hashimoto's thyroiditis may also develop problems. In rare cases it can affect patients with primary hypothyroidism and thyroid carcinoma. Those with toxic multinodular goitre, toxic adenoma or diffuse micronodular goitre are usually unaffected.

TED usually occurs in middle age but it may affect a teenagers to those in their 80s (it may even affect newborn babies). Women are much more commonly affected than men (approximately 4 women are affected for each man).

Factors that affect the development of TED include:

• Heredity (30% of patients have a family history of TED and if a twin has TED there is a 1/3-2/3 chance that the other twin will develop problems)
• Stress (this is difficult to define but is thought to play a part in the development of TED)
• Smoking (TED is usually worse in those who smoke cigarettes)
• Environment (because the brother or sister of an affected twin does not always develop TED, as yet unidentified environmental factors must be important)

Source: Mr Naresh Joshi