Thyroid Eye Disease (TED) Treatments at UPMC

Thyroid eye disease (TED) is a health issue that results in sensitive, bulging eyes. It occurs in about one out of three people who have an autoimmune disorder called Graves' disease.

If you have Graves' disease, your immune system attacks the thyroid gland and tissues around the eye. Your thyroid gland then starts making too much thyroid hormone.

TED can reduce your quality of life. In rare cases, it can lead to vision loss.

What's Our Approach to TED?

At UPMC, we assess how severe your TED symptoms are before we treat you.

Milder symptoms of TED often go away on their own. More severe ones need treatment.

TED treatment may be as simple as home remedies like lubricating gel and eye drops. Doctors treat more severe cases with medicine or surgery.

A complete eye exam to assess TED

At UPMC, our approach is to start by giving you a complete medical eye exam.

This exam:

• Detects lifestyle factors you can change, like smoking. Smoking can make TED worse. We refer smokers to our UPMC Tobacco Treatment Service.
• Differs from a primary vision care exam for glasses or contacts. It's much more in-depth. The eye doctor will inspect your eyes and eyelids for signs of TED.
• Helps doctors know how severe TED is. This helps them decide on treatments.

How Do You Treat Thyroid Eye Disease at UPMC?

Lifestyle changes and over-the-counter medicine to treat TED

In mild cases, lifestyle changes and OTC remedies may be enough to treat TED.

These include:

• Eye drops and gels.
• Prism lenses for double vision.
• Quitting smoking.
• Raising the head of your bed to relieve eye pressure.
• Wearing sunglasses.

Prescription drugs or surgery to treat TED

For people with moderate to severe TED, your doctor may suggest:

• Corticosteroids. A steroid like prednisone may help relieve TED symptoms. It can reduce swelling in the tissues around the eyes.
• Teprotumumab. This new medicine treats TED by blocking a protein that causes inflammation in the eye. A doctor or nurse must give it to you through a vein.
• Surgery. Your doctor may advise orbital decompression eye surgery if TED causes vision problems. This technique eases pressure on the optic nerve and helps the eye move back into place. Surgery on your eyelid can also help a bulging eye go back to its normal position.

How Do You Treat Hyperthyroidism in People With TED?

Most people with TED have hyperthyroidism (an overactive thyroid gland). Rarely, TED occurs in people with normal or low thyroid levels.

One treatment goal is to get your thyroid working normally again.

Treatments for hyperthyroidism may include:

• Antithyroid drugs. These drugs block the thyroid from making new hormone.
• Radioiodine. It kills the cells that make the thyroid hormone. But doctors don't advise it for moderate or severe TED, as it can worsen eye disease.
• Surgery. Your doctor may advise orbital decompression eye surgery if TED causes vision problems. This technique eases pressure on the optic nerve and helps the eye move back into place. Surgery on your eyelid can also help a bulging eye go back to its normal position.
• Have enlarged thyroid glands.
• Have had bad reactions to antithyroid drugs.
• Plan to conceive soon and shouldn't take antithyroid drugs.

Why Choose UPMC For Thyroid Eye Disease Care?

We take a team approach to TED treatment. We're experts at diagnosing and treating TED.

Instead of seeing just one doctor, you may see:

• An ear, nose, and throat doctor.
• An ophthalmologist.
• Endocrine doctors and surgeons.

Other specialists may provide consults when needed.

At UPMC, we're on the cutting edge of research for all types of thyroid problems. You may also be able to take part in clinical trials.

Make an Appointment at The Multidisciplinary TED Clinic at UPMC

To make an appointment with one of our TED experts, call 412-755-2731.