These thyroid eye disease symptoms are a medical emergency.
Thyroid eye disease can range from mild to severe. Some people progress slowly over time. Others may be steady for years. In some cases, severe symptoms of thyroid eye disease can come on suddenly and be a medical emergency. When this happens, it’s critical to call your doctor or go to the emergency room to save your eyesight.
When Is Thyroid Eye Disease an Emergency?
Thyroid eye disease (also called Graves’ orbitopathy) becomes an emergency when it is threatening your eyesight. Vision loss from thyroid eye disease may be irreversible. Usually, treatment can help keep symptoms from progressing or becoming severe. However, if severe symptoms come on suddenly, you may need emergency care to treat the problem.
Call your doctor or go to the emergency room if you notice the following warning signs of an emergency:
- Sudden vision loss
- Colors suddenly appear dull or different
- Severe eye pain
Emergency Surgery for Thyroid Eye Disease
These warning signs suggest you are experiencing compressive optic neuropathy, a complication of thyroid eye disease. This is when inflammation and swelling behind the eye is putting pressure on the optic nerve. This can lead to permanent loss of vision.
In this instance, you may need a procedure called orbital decompression surgery. In this surgery, the doctor removes parts of the bones between the eye, nose, outer eye socket, and potentially under the eye. This creates more space for the fat and muscle around the eye. Your doctor may remove some of this fat as well. All of this helps to reduce some of the pressure that’s caused by thyroid eye disease.
Treatment for Corneal Damage
Another potential emergency for thyroid eye disease is corneal exposure. Your cornea is the clear layer at the front of your eye. Thyroid eye disease can cause the eyelids to retract (pull back) and the eyes to bulge out. Because of this, the eyelids can’t properly cover the cornea.
This can become an emergency if the cornea begins scarring. Scratches to the cornea may leave scars, which might cause eye pain and sensitivity to light. In some cases, it may lead to a perforation (hole) and an infection. You should see a doctor if you experience:
- Severe eye pain
- Sudden blurriness or change in vision
- Red and watery eyes
Corneal scarring might require a corneal transplant—when a surgeon removes your cornea and replaces it with a cornea from a donor.
Knowing Your Risk
Thankfully, the majority of people with thyroid eye disease experience mild symptoms and don’t have sight-threatening emergencies. You can reduce your risk of complications (including vision loss) with early diagnosis and treatment. Learn more here about how thyroid eye disease is treated.
- Graves’ eye disease (Graves’ ophthalmopathy or Graves’ orbitopathy). American Thyroid Association. (Accessed on July 14, 2021)
- Orbital decompression. Kellogg Eye Center, University of Michigan Health System, 2015. (Accessed on July 15, 2021)
- Treatment of Graves' orbitopathy (ophthalmopathy). Waltham, MA: UpToDate. (Accessed on July 14, 2021)