Reviewed by: HU Medical Review Board | Last updated: May 2023
Vision problems due to thyroid eye disease (TED) can be frustrating and perhaps even scary at times. The unknowns of TED include how it can impact vision. Everyone is different, and your symptoms can vary.
Because TED is rare, it requires management from a specialized care team. An ophthalmologist is a doctor who specializes in eyes and vision. These doctors can diagnose and treat advanced conditions and are able to perform surgery.1
There are more than 20,000 ophthalmologists in the United States, but most are not TED specialists. TED specialists are doctors who are experienced in diagnosing and treating TED.2
Understanding the possible causes of your vision problems can help you guide your conversation with your doctor about ways to decrease your symptoms.
Double vision (diplopia)
Double vision (seeing 2 objects where there is 1) and trouble focusing occur because the muscles that keep the eyes aligned become damaged due to TED. Your doctor may call this problem diplopia (dip-low-pee-uh).3
Blurred vision affects about 3 in 10 people with TED. Images might look blurry or out of focus. Blurred vision may be caused by:3
- Damage to the thin, clear layer of the front of the eye (cornea)
- Swollen tissues and muscles behind the eye squeezing the optic nerve
Dry eyes are also common in TED. Swelling of the fat and muscles behind the eye can cause the eye to bulge. This might look like a person is staring at all times. It also makes it harder to blink, which can lead to dry eyes. Also, the eyelid can be pulled back or retracted, making it even harder to blink.3
Dry eyes lead to irritated, sore, watery eyes that can cause periodic blurred vision.3
Loss of color vision
In severe cases, TED may cause a change in color vision. A person might notice that colors are dulled or not as bright. In rare cases, complete loss of color vision can occur. This could mean that the optic nerve is damaged and there is a risk of completely losing sight. About 6 out of 100 people with TED have some color vision loss from damage to the optic nerve.3
The optic nerve is a bundle of nerves that sends impulses from the eye to the brain for normal vision. Although rare, swelling of the muscles and fat behind the eye can squeeze the optic nerve. This is known as optic nerve compression or optic neuropathy. It can lead to vision loss if left untreated. Emergency surgery may be needed to save vision of a person with this condition. Talk to your doctor immediately if you notice vision loss.3
The goal of treatment in the acute phase is to reduce inflammation. Treatment goals in the inactive phase focus on repairing damage of tissue.4,5
The treatments most commonly used for the different phases of TED include:4,6
- Monoclonal antibody drugs
- Supportive treatments
Find a TED specialist
Finding a TED specialist often starts with the eye doctor you are currently seeing. A referral to a TED specialist may need to be approved through your insurance. Seeing a specialist is important to the overall outcome of your disease.7
To find a TED specialist in your area, visit TEDspecialists.com or ThyroidEyes.com.