Early diagnostic signs of thyroid eye disease

Thyroid eye disease (TED) is a rare, often undiagnosed, disfiguring autoimmune condition.

This diagnostic information is intended for GPs, endocrinologists, opticians and any other medical professional responsible for referring patients to an ophthalmologist for diagnosis and treatment of thyroid eye disease. It is also for people who are experiencing changes in their eyes and are uncertain of the cause.

Over 50% of patients with an underlying thyroid condition develop thyroid eye disease – over half of them go undiagnosed

How to recognise TED

The early signs of thyroid eye disease are subtle but very obvious once you know what to look for. The following is a list of early – and very easily missed – thyroid eye disease symptoms indicating a patient should be referred to an ophthalmologist

Any ONE of the following can indicate thyroid eye disease especially in a patient with an underlying thyroid condition.

There is a clear connection between thyroid disfunction and thyroid eye disease. TED can also occur (rarely) in a patient without a known thyroid condition.

It should be noted that patients presenting with changes to their eyes are often in a state of trauma and can be very emotional. Patients can see changes to their eyes that may not be perceptible to others.

Early diagnostic signs of thyroid eye disease (TED)

1. ANY change in the appearance of the eyes
2. An intense stare
3. White of the eye showing above the iris
4. One eye slighter wider or a different size
5. Eyes looking in different directions
6. Dry eye which presents as grittiness, watering or sharp pain in the eye
7. Puffiness above or below the eye
8. Redness of the lids
9. Bloodshot eyes
10. Difficulty moving the eyes, they may feel “stiff”
11. Blurred or double vision
12. Pain in or behind the eye especially when looking up, down or sideways.
13. Any swelling or feeling of fullness in upper or lower lids
14. Light sensitivity including difficulty night driving
15. Chemosis that presents as a clear gel in the lower eyelid

TEDct is a charity working to improve the lives of people with thyroid eye disease. Anyone affected by TED can join the TEDct support group Thyroid Eye Disease Support UK