Disease burden & unmet needs Physical impact

All too visible: The physical damage of TED is devastating

The long-term impact of TED, including serious vision impairment, can be shattering. TED can reduce the patient’s independence, ability to work, and self-confidence.12,19 Even early Active TED can have a substantial negative effect on patients and once TED has become inactive, multiple surgeries may be necessary to correct the damage.7,11 These procedures are often only partially successful and can have significant impact on the lives of patients and their families.11

Physical Sequelae

Eyelid retraction

An early sign of Active TED is retraction of the eyelids. This may lead to lagophthalmos or the inability to fully close the eyes. The resulting corneal and conjunctival exposure can lead to dry eye symptoms and, for some patients, ulcerations and infections.7

Click to enlarge

Proptosis or exophthalmos

Proptosis or exophthalmos is the bulging of the eyes that can prevent full closure of the eyelids, exposing the cornea.7 Corneal ulceration, pain, and sleeplessness are often the result. The bulging also changes patients’ physical appearance.

Exophthalmos and appearance changes statistics chart Exophthalmos and appearance changes statistics chart

in a single-center, Australian observational study (n=128) said they’ve had to mask the changes to their appearance caused by TED to some degree.20

Strabismus

In addition to affecting self-perception, strabismus or misalignment of the eyes can also interfere with visual acuity.7,20 For many patients, multiple surgeries to correct strabismus and other TED-related conditions are needed.11 

Strabismus and thyroid vision changes statistics chart Strabismus and thyroid vision changes statistics chart

in the same study (n=128) said that visual function changes caused by TED severely limit their ability to engage in hobbies or pastimes.20

Diplopia

Commonly arising from strabismus, double vision is one of the most debilitating symptoms of TED. It causes significant functional impairment for patients, inhibiting their ability to drive, read, or watch TV.20

Diplopia and work ability icon Diplopia and work ability icon

A controlled, descriptive study found German patients with TED and diplopia had significantly worse perceptions of their general health than those with TED but no diplopia (P<0.001; N=102).21

Vision loss / Optic neuropathy

Inflammation and the enlargement of muscles and adipose tissue around the orbit that begin during Active TED can create pressure on the optic nerve, potentially leading to loss of sight.7 Orbital decompression surgery may be needed to mitigate this.11 

Orbital decompression surgery statistics chart Orbital decompression surgery statistics chart

with TED who underwent orbital decompression surgery had substantial post-surgical limits to their eye movement (ductions decreased >5° in at least one meridian) in a retrospective cohort study conducted at a US orbital clinic.11

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