Beholder’s Eyes: Understanding Thyroid Eye Disease (TED)

eyeIn the Dungeons & Dragons tabletop roleplaying game, a beholder is a floating monster with a huge central eye, a gaping mouth, and tentacles topped with smaller eyes.

Though thyroid eye disease, also called TED, is by no means as horrible as the creature, it certainly feels that way to a person who has it. A thyroid eye disease, though painful, is only a symptom of a bigger problem: an autoimmune response that triggers thyroid overactivity. This causes the muscles that control the movement of the eye to swell, and because there is hardly room in the socket, the eye is pushed forward.

TED is a treatable illness, but before you dread a visit to the doctor, expect common treatments such as:

  1. Eye lubricants

This is for stage-one TED and for mild cases. Thyroid eye doctors recommend hypromellose eye drops, which act as artificial tears to lubricate the eyes. This is especially useful for TED cases where the tear glands are affected, or the eyes bulge significantly so that the eyelids can’t properly dispense lubricating fluid.

  1. Immunosuppressants

These steroidal drugs dull the immune system, so they’d stop bugging your eye muscles. Taking steroid-based medicine usually comes with other drugs to counteract its side effects. Doctors prescribe an IV drip for those with severe or urgent TED.

  1. Iodine treatment

Because an autoimmune process – meaning your own immune system attacks your body by mistake –also attacks the thyroid gland, some doctors will also advise iodine treatment to stabilize thyroid activity.

  1. Surgery

This is very rare, occurring in only 5% of TED cases, where swelling damages the optic nerve. Because the optic nerve carries visual information to the brain, this may cause permanent impairment. Surgery realigns the muscles so they have room to swell without touching the nerve, but a more mundane reason to want one is for cosmetic purposes.

  1. Eye devices

Double vision also happens in even rarer cases. Specialists will then use an eye patch or a similar device on one eye to correct it. But if you don’t want to look like you’re staring at everything and everyone, a trip to a specialist is likely in order.