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What Doctors Want Women Over 50 to Know About Thyroid Eye Disease Symptoms and the Link to Menopause

The condition affects women five times more than men and can be triggered by hormone changes

If you’re experiencing eye dryness, irritation, vision issues or your eyes look different, you may have symptoms of thyroid eye disease. If you don’t have diagnosed thyroid disorder, that can sound strange. But it turns out some people actually first discover they have thyroid trouble when they notice changes in their eyes.

The good news? If problems with your eyes stem from thyroid issues, you can treat it. In fact, thyroid eye disease can even go away on its own. Here, we reveal the thyroid eye disease symptoms to watch out for, who’s most at risk and explain the difference between the two stages of the condition.

What is thyroid eye disease?

Thyroid disease is an umbrella term that includes having an overactive (hyperthyroidism) or an underactive (hypothyroidism) thyroid. A thyroid that doesn’t release a normal amount of hormones can cause thyroid eye disease (TED), an autoimmune condition that affects roughly one million Americans each year.

“TED occurs when the immune system attacks the tissue around the eye, causing inflammation and tissue expansion,” explains Raymond Douglas, MD, PhD, a Beverly Hills-based ophthalmologist and a professor of surgery in the division of ophthalmology at Cedars-Sinai Hospital in Los Angeles.

About 80% of thyroid eye disease cases are a result of hyperthyroidism, says Dr. Douglas. However, you can also develop it if you have hypothyroidism, or less commonly, with a normally functioning thyroid, he adds.

Thyroid eye disease is often related to Graves’ disease, an autoimmune disorder that can cause the thyroid to be overactive. But not everyone who has Graves’ disease will develop TED. “Only half of the people who have Graves go on to have TED,” says Dr. Douglas.

Common thyroid eye disease symptoms

While symptoms and severity differ from person to person, there are common signs, says Michael Kazim, MD, an ophthalmologist and clinical professor of ophthalmology at Columbia University Irving Medical Center’s Harkness Eye Institute in New York City. Thyroid eye disease symptoms include:

  • Red, scratchy, dry or irritated eyes
  • Bags under the eyes
  • Swollen or puffy eyelids
  • A gritty feeling in the eyes
  • An abnormal eyelid position that gives off a staring look
  • Bulging of one or both eyes
  • Light sensitivity, especially to bright lights

“In more advanced cases, a person can experience double or blurred vision, pain in the eye socket or very rarely, vision loss due to pressure on the optic nerve,” explains Dr. Kazim.

Check out the video below for more signs and symptoms:

Stages of thyroid eye disease

If you’ve been diagnosed with thyroid eye disease, you’re likely wondering what the difference is between the stages: active and stable. A quick run-down:

Stage 1: This is the active or acute phase, which is when inflammation sets in and thyroid eye disease symptoms start to occur. This stage lasts about a year, with a minimum of three to 18 months, says Dr. Douglas. Since this is a progressive phase, symptoms usually worsen. Treatment focuses on self-care remedies, over-the-counter or prescription drug treatment.

Stage 2: This is the stable phase, also sometimes called the chronic or inactive stage. It’s during this time inflammation and other symptoms have subsided or decreased and the disease stops progressing. If there’s any damage to your eyes that occurred during the active phase, your doctor may suggest a more intensive course of treatment or surgery to help correct eye appearance or vision issues.

4 risk factors for thyroid eye disease

Some people have a higher chance of developing TED. Risk factors include:

1. Being a woman

According to the American Academy of Ophthalmology, TED affects women five times more than men. “This could be because women are more likely than men to have an autoimmune thyroid disease such as Graves,” says Andrew G. Lee, MD, neuro-ophthalmologist and chair of the department of ophthalmology at Houston Methodist Hospital in Houston, TX.

“The significant hormone changes occurring during menopause can also trigger TED,” adds Dr. Kazim. That includes a drop in estrogen, which typically has a protective effect against certain autoimmune conditions, and progesterone.

2. Smoking

“Smokers are, on average, eight times more likely to get TED,” Dr. Kazim says. “And if you get the disease, it’s going to be much worse if you’re a smoker.” One study review in the Kansas Journal of Medicine found that smoking has been shown to worsen thyroid eye disease symptoms and decrease treatment response.

3. Having sleep apnea

“Something else we’ve found that can worsen thyroid eye disease is untreated sleep apnea,” says Dr. Kazim. How? “Sleep apnea produces a low blood oxygen level, and the body responds by releasing proteins into the blood that promote inflammation. This can worsen inflammation around the eyes.”

4. A family history

A Black woman rubbing her eyes due to thyroid eye disease symptoms

“If you have any family member who had Graves’ disease or TED, you’re 30% more likely of having thyroid eye disease,” says Dr. Douglas.

Thyroid eye disease symptoms: The bottom line

Knowing your risk factors — and the key symptoms to be on the lookout for — can help you spot possible signs of the condition early on. If you do notice anything that seems off, schedule a visit with your primary care doctor and/or an endocrinologist to check your thyroid, as well as an eye specialist to examine your vision. Together, they can create a plan that gets your thyroid levels back in balance and reduces the symptoms of thyroid eye disease.

More ways to keep your thyroid healthy:

How Vitamin D for Thyroid Helped One Woman Beat Fatigue: “I Feel Like I’ve Aged Backward!”

Experts Say This Ancient Herb Can Help Rejuvenate a Weary Thyroid — And Your Energy

How Your Thyroid Can Impact Hair Loss, Plus 6 Easy Doctor-Backed Ways to Cure It

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

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