What are Symptoms of Thyroid Eye Disease?

Thyroid eye disease can affect men or women with hyperthyroidism or Grave’s Ophthalmopathy in a variety of ways.

Classifying Thyroid Eye Disease by Symptoms

This a system that is used by medical professionals to classify the stage of thyroid eye disease based on certain signs and symptoms of thyroid eye disease.

The system is known by the acronym NOSPECS and uses this acronym to list the seven stages of thyroid eye disease.

Stage 0 Thyroid Eye Disease

The first stage of thyroid eye disease is stage 0 which is characterized by No signs or symptoms.

At this stage in the disease, the individual has no complaints and there are no findings in a complete eye exam.

Stage 1 Thyroid Eye Disease

Stage 1 of thyroid eye disease is characterized by Only signs without any symptoms.

These signs are identified in a complete eye exam and can include eyelid lag, eyelid retraction, and a stare appearance.

Stage 2 Thyroid Eye Disease

Stage 2 of thyroid eye disease is characterized by Soft tissue involvement.

The soft tissue involvement can include swelling of or around the eyelids, swelling of the conjunctiva on the front of the eye, or redness of the eyes.

These symptoms are among the first noticed by an individual with thyroid eye disease.

Stage 3 Thyroid Eye Disease

Stage 3 of thyroid eye disease is characterized by Proptosis, or the protrusion of the entire eyeball from the orbit.

This proptosis can be noticed one eye relative to another or it can be both eyes that are protruding and is compared to a normal set of values.

Stage 4 Thyroid Eye Disease

Stage 4 of thyroid eye disease is characterized by Extraocular muscle involvement.

When the extraocular muscles are involved, thyroid eye disease can cause a restriction in a certain gaze, can cause swelling around the eye, and can result in double vision since the eyes cannot move equally together.

The extraocular muscles are considered involved when there is detectable inflammation and swelling on an MRI or CT of the orbits.

Stage 5 of Thyroid Eye Disease

Stage 5 of thyroid eye disease is characterized by corneal involvement.

The cornea will typically be considered involved in the thyroid eye disease when exposure keratopathy develops.

When the eye exhibits proptosis, the eyelids may not completely cover the front of the eye when the eyes are closed.

This incomplete lid closure can lead to the cornea being exposed for an extended period of time, such as while sleeping.

When the cornea is exposed, it can become damaged and cause dryness, irritation, and result in scarring if untreated.

Stage 6 of Thyroid Eye Disease

Stage 6 of thyroid eye disease is characterized by Sight loss.

This stage is the most severe and the loss of vision is caused by the damage to the optic nerve.

The inflammation associated with thyroid eye disease can reach the back of the eye and affect the optic nerve.

If the nerve is inflamed for a long time, the nerve will get compressed and can loose the ability to transmit information to the brain.

Managing Thyroid Eye Disease

Regardless of the stage, thyroid eye disease is a condition with severe consequences if it is not managed appropriately.

That is why it is important to have routine eye exams each year to monitor the progression of the disease.