TED Medical Dictionary
A reference point for TED terminology
Words related to thyroid eye disease
Euthyroid – having normal thyroid gland function.
Graves’ disease – an autoimmune condition causing an overactive thyroid gland, sometimes associated with thyroid eye disease.
Hyperthyroid – overactive thyroid.
Hypothyroid – underactive thyroid.
Thyroid eye disease (TED) – an autoimmune condition affecting the tissues behind the eyes, usually related to dysfunction of the thyroid gland.
Symptoms (what the patient describes)
Diplopia – “double vision” i.e. seeing two of an object when there is only on.
Photophobia – sensitivity to bright light.
Proptosis – bulging or prominence of the eyes due to swelling of the soft tissues (fat and muscles) behind the eyes.
Squint/strabismus – misalignment of the eyes usually due to involvement of the muscles controlling eye movement, and usually associated with double vision.
Symptoms (what the patient describes)
Diplopia – “double vision” Seeing two of an object when there is only one.
Photophobia – sensitivity to bright light.
Proptosis – bulging or prominence of the eyes due to swelling of the soft tissues (fat and muscles) behind the eyes.
Squint/strabismus – misalignment of the eyes usually due to involvement of the muscles controlling eye movement, and usually associated with double vision.
Signs (what the doctor sees when examining you)
Pretibial myxoedema – localised lesions of the skin resulting from deposition of hyaluronic acid, most commonly in the pretibial (shin) area of the lower legs.
Squint/strabismus – misalignment of the eyes usually due to involvement of the muscles controlling eye movement, and usually associated with double vision.
Soft tissue swelling – swelling of the lids.
Tests
Exophthalmometer – a hand held medical instrument designed to measure the forward protrusion of the eye. This instrument provides a method of evaluating and recording the progression and regression of the prominence of an eye caused by disorders such as thyroid disease and tumors of the orbit
Field of binocular single vision – a graphical representation of the area in which an object placed in front the patient would appear single rather than double.
Hess chart – a special chart used by orthoptists to record the extent of movement of each eye.
Ishihara plates – coloured number charts used to test colour vision and optic nerve function.
Orthoptics – the evaluation and non-surgical treatment of conditions such as TED which result from an imbalance of the eye muscles.
Slit Lamp – an instrument consisting of a high-intensity light source that can be focused to shine a thin sheet of light into the eye.
Snellen Chart – a standardised chart used to check vision.
Tonometer – a medical device for measuring the pressure inside eyes
Uniocular field of fixation – the range of eye movement of each eye as an angular rotation.
Treatment
Blepharoplasty – Removal of skin and or fat (debulking) from the upper or lower lids.
Floor – the lower part of the eye socket, between the eye socket and the maxillary sinus in the cheek.
Immunosuppressants – drugs which suppress the immune system (which is attacking the tissues behind the eyes in TED); they include steroids (the main treatment), azathioprine, tacrolimus, cyclosporin, mycophenolate and rituximab.
Lateral wall – the outer wall of the eye socket.
Lower lid raising – lifting of the lower lids using autologous (from your own body) materials such as hard palate, or donor tissue (such as Alloderm).
Lubricants – “moisturising” eyedrops, gels or ointments used to treat dry or exposed eyes (more common when the eyes are protruding or proptosed); eg. Hypromellose, Viscotears and Lacrilube.
Medial wall – the inner wall of the eye socket (at the nose end).
Orbital decompression – removal of bone from one or more walls of the bony eye socket, in order to create more space for the enlarged soft tissues behind the eyes; it may be performed in an emergency situation to relieve pressure on the optic nerve and prevent visual loss, or more commonly as an elective procedure to reduce the prominence of the eyes, resulting in improved appearance and eyelid closure.
Prisms – special lenses applied to the surface of or incorporated into your glasses to eliminate double vision while looking straight ahead.
Radio iodine I131 – a single dose of radioactive iodine given either as a capsule or dissolved in water used to treat hyperthyroidism; it can be associated with a flare up of thyroid eye disease.
Rehabilitative surgery – surgery which attempts to restore the tissues to their pre-disease state. It includes orbital surgery (such as decompression), squint surgery (to realign the muscles and straighten the eyes) and lid surgery such as upper lid lowering, lower lid raising and blepharoplasty.
Upper lid lowering – surgery to lower the position of the upper lid in order to improve appearance, comfort of the eyes and eyelid closure.
Miscellaneous
Active (wet) disease – TED with a component of inflammation and therefore responsive to immunosuppression; usually early in Rundle’s curve.
Amsterdam Declaration – a pledge aimed to raise awareness of Graves’ Orbitopathy (TED) among health professionals and the public and to draw attention to the fact that treatment of patients with this condition can and should improve.
Bilateral – “both” sides (right and left eyes).
CIRTED (Combined Immunosuppression and Radiotherapy in thyroid eye disease) – a trial that is currently being undertaken in multiple centres throughout the UK to determine the best treatment for thyroid eye disease in addition to the already well established treatment with steroids.
Endocrinologist – a medical professional who specialises in the treatment of hormone related disorders, including hyperthyroidism of hypothyroidism.
Inactive/burnt out (dry) disease – TED in which the inflammation has resolved and is therefore unresponsive to immunosuppression; this does not necessarily mean that the tissues have returned to their normal pre-disease state – patients may be left with permanent eye muscle scarring (resulting in double vision), prominent staring eyes and an increase in the amount of soft tissue around the eyes; late in Rundle’s curve.
Oculoplastic surgeon – an ophthalmologist who specialises in the treatment of diseases affecting the soft tissues and/or bones around the eyes.
Ophthalmologist – a medical professional who specialises in the medical and/or surgical treatment of eye diseases.
Rundle’s curve – a graphical curve describing the time course of thyroid eye disease; there is initial worsening over a few months to a peak, followed by gradual spontaneous improvement over a couple of years, ending in a chronic (i.e. lasting for a long time) “burnt out phase”.
TEAMed – the UK working group Thyroid Eye Disease Amsterdam Declaration Implementation Group.
