Christofides. Patients need to know that thyroid eye disease can occur “at any time, in anyone, whether they have thyroid disease or not,” she tells EndocrineWeb.

Will my eyes go back to normal after treatment? Most patients think once their medical doctor treats the body’s thyroid problem the eyes will go back to normal. This is often not the case. In some patients the eyes worsen in the months and years after medical treatment despite the body being stabilized.

The symptoms that occur in thyroid eye disease include dry eyes, watery eyes, red eyes, bulging eyes, a “stare,” double vision, difficulty closing the eyes, and problems with vision. Research suggests that the cause of thyroid disease and thyroid eye disease is an autoimmune disorder.

Total thyroidectomy is one of the definitive treatments for Graves’ disease. This case describes the rare recurrence of thyroid eye disease (TED) and thyrotoxicosis due to thyroid remnant tissue.

Graves’ ophthalmopathy doesn’t always improve with treatment of Graves’ disease. Symptoms of Graves’ ophthalmopathy may even get worse for three to six months. After that, the signs and symptoms of Graves’ ophthalmopathy usually become stable for a year or so and then begin to get better, often on their own.

Some patients with apparent Graves’ disease do not have an autoimmune thyroid disorder. One of the most common causes of hyperthyroidism is Graves’ disease, an autoimmune process in which the patient’s immune cells make antibodies against the thyroid stimulating hormone (TSH) receptor on the thyroid gland cells.

Approximately one million Americans are diagnosed with Graves’ eye disease each year. Women are five to six times more likely than men to get the disease. Cigarette smokers are at significantly increased risk to develop the disease, and when they do, often have more severe and prolonged activity that threatens vision.

Early symptoms of thyroid eye disease are itching, watering or dry eyes and a feeling of grittiness of the eyes. Some people may notice a swelling around the eyelids and sometimes the front of the eye becomes swollen.

A spokesperson for the company said teprotumumab will cost $14,900 per vial, with full treatment over 6 months approximately 23 vials, and that the wholesale acquisition cost for that amount is $343,000, with an annual net realized price of $200,000.

Cause of Graves’ ophthalmopathy Graves’ ophthalmopathy results from a buildup of certain carbohydrates in the muscles and tissues behind the eyes — the cause of which also isn’t known. It appears that the same antibody that can cause thyroid dysfunction may also have an “attraction” to tissues surrounding the eyes.

The treatment options for vision-threatening problems in thyroid eye disease include corticosteroids or other anti-inflammatory medications, radiation and surgery.

These symptoms of redness, irritation, pressure and double vision are treated with lubrication, anti-inflammatory medications and prisms for the double vision, and will require some time to stabilize before your doctor will recommend surgical intervention. Typically, the active or inflammatory stage of thyroid eye disease lasts one to three years.

This also can be surgically improved. The muscles which control movement of the eyes may be increased in size by the swelling. This can create problems with double vision and focusing. Prism glasses may be helpful, and this can also be improved by surgically moving the eye muscles.

Research suggests that the cause of thyroid disease and thyroid eye disease is an autoimmune disorder. An imbalance or recognition problem occurs in the immune system.