Disease burden & unmet needs Patient Function

Beyond the orbit: TED damage is also psychosocial

Thyroid eye disease can have a significant impact on each individual patient, though the manifestations are not always visible. Pain, impairment of sight, depression, and loss of self-confidence all have a substantial effect on patients’ well-being.7,12,21

A variety of studies and surveys have shown
how TED affects patient quality of life:

Thyroid eye disease and appearance statistics chart Thyroid eye disease and appearance statistics chart Thyroid eye disease and appearance statistics chart

surveyed in a single-center Australian study said the changes TED had caused to their appearance significantly interfered with psychosocial functioning  (N=128)20

Graves ophthalmopathy and appearance graphic


Thyroid eye disease and confidence statistics chart Thyroid eye disease and confidence statistics chart Thyroid eye disease and confidence statistics chart

in a controlled, prospective, descriptive study at a German orbital clinic reported a loss of self-confidence due to their disease (N=250)19

Graves ophthalmopathy and confidence graphic


Thyroid eye disease and anxiety chart Thyroid eye disease and anxiety chart Thyroid eye disease and anxiety chart

at a German academic clinic who responded to a questionnaire on quality of life and use of psychotherapy reported emotional distress, including 40% reporting anxiety and 22% depression (N=102)21

Graves eye disease and anxiety graphic


Thyroid eye disease surgery dissatisfaction chart Thyroid eye disease surgery dissatisfaction chart Thyroid eye disease surgery dissatisfaction chart

in a single US county who were surveyed in a long-term study with a median follow-up of nearly 10 years were dissatisfied with their appearance, including some even after surgery (N=120)17

Graves eye disease surgery dissatisfaction graphic


Thyroid eye disease management icon Thyroid eye disease management icon

Regular, active monitoring of TED should always include questions about the patient’s mental health, daily functioning, and ability to work.

This site is dedicated to advancing the understanding of thyroid eye disease.
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References:
  1. Bahn RS. Graves' ophthalmopathy. N Engl J Med. 2010;362:726-738. 
  2. Mamoojee Y, Pearce SHS. Natural History. In: Wiersinga WM, Kahaly GJ (eds): Graves’ Orbitopathy: A Multidisciplinary Approach – Questions and Answers. Basel, Karger. 2017:93-104.
  3. Bartley GB. The epidemiological characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Tr Am Ophth Soc. 1994;92:477-588.
  4. Laurberg P, Berman DC, Pedersen IB, Andersen S, Carlé A. J Clin Endocrinol Metab. 2012;92(7):2325-2332.
  5. Perros P, Crombie AL, Matthews JN, Kendall-Taylor P. Age and gender influence the severity of thyroid-associated ophthalmopathy: a study of 101 patients attending a combined thyroid-eye clinic. Clin Endocrinol (Oxf). 1993;38(4):367-372.
  6. Tsui S, Naik V, Hoa N, et al. Evidence for an association between thyroid-stimulating hormone and insulin-like growth factor 1 receptors: a tale of two antigens implicated in Graves’ disease. J Immunol. 2008;181:4397-4405.
  7. Barrio-Barrio J, Sabater AL, Bonet-Farriol E, Velázquez-Villoria Á, Galofré JC. Graves' ophthalmopathy: VISA versus EUGOGO classification, assessment, and management. J Ophthalmol. 2015;2015:249125. 
  8. Kilicarsan R, Alkan A, Ilhan MM, et al. Graves’ ophthalmopathy: the role of diffusion-weighted imaging in detecting involvement of extraocular muscles in early period of disease. Br J Radiol. 2015;88(1047):20140677.
  9. Smith TJ, Hegedüs L. Graves’ disease. N Engl J Med. 2016;375:1552-1665.
  10. Villadolid MC, Yokoyama N, Isumi M, et al. Untreated Graves’ disease patients without clinical ophthalmopathy demonstrate a high frequency of extraocular muscle (EOM) enlargement by magnetic resonance. J Clin Endocrinol Metab. 1995;80(9):2830-2833.
  11. Rootman DB, Golan S, Pavlovich P, Rootman J. Postoperative changes in strabismus, ductions, exophthalmometry, and eyelid retraction after orbital decompression for thyroid orbitopathy. Ophthal Plast Reconstr Surg. 2017;33:289-293.
  12. Ponto KA, Merkesdal S, Hommel G, Pitz S, Pfeiffer N, Kahaly GJ. Public health relevance of Graves’ orbitopathy. J Clin Endocrinol Metab. 2013;98:145-152.
  13. Bruscolini A, Sacchetti M, La Cava M, et al. Quality of life and neuropsychiatric disorders in patients with Graves' orbitopathy: current concepts. Autoimmun Rev. 2018;17:639-643. 
  14. Vardizer Y, Berendschot TTJM, Mourits MP. Effect of exophthalmometer design on its accuracy. Ophthal Plast Reconstr Surg. 2005;21(6):427-430.
  15. Maheshwari R, Weis E. Thyroid associated orbitopathy. Indian J Ophthal. 2011;60(2):88-93. 
  16. Dolman PH. Grading severity and activity in thyroid eye disease. Ophthal Plast Reconstr Surg. 2018;34:S34-S40.
  17. Bartley GB, Fatourechi V, Kadrmas EF, et al. Long-term follow-up of Graves ophthalmopathy in an incidence cohort. Ophthalmology. 1996;103:958-962.
  18. Mitchell AL, Goss L, Mathiopoulou L, et al. Diagnosis of Graves' orbitopathy (DiaGO): Results of a pilot study to assess the utility of an office tool for practicing endocrinologists. J Clin Endocrinol Metab. 2015;100(3):E458-E462.
  19. Ponto KA, Pitz S, Pfeiffer N, Hommel G, Weber MM, Kahaly GJ. Quality of life and occupational disability in endocrine orbitopathy. Dtsch Arztebl Int. 2009;106:283-299.
  20. Park JJ, Sullivan TJ, Mortimer RH, Wagenaar M, Perry-Keene DA. Assessing quality of life in Australian patients with Graves' ophthalmopathy. Br J Ophthalmol. 2004;88:75-78.
  21. Kahaly GJ, Petrak F, Hardt J, Pitz S, Egle UT. Psychosocial morbidity of Graves’ orbitopathy. Clin Endocrinol. 2005;63:395-402.
  22. Yang DD, Gonzalez MO, Durairaj VD. Medical management of thyroid eye disease. Saudi J Ophthalmol. 2011;25:3-13.
  23. Strianese D, Iuliano A, Ferrara M, et al. Methotrexate for the treatment of thyroid eye disease. J Ophthalmol. 2014;2014:128903.
  24. Yakopson VS, Carrasco JR, Sharma P, Rabinowitz MP, Stefanyszyn MA. Effect of intraorbital steroid injections on intraocular pressure in thyroid eye disease. Thyroid Disorders Ther. 2015;4(1):1000173.
  25. Gillespie EF, Smith TJ, Douglas RS. Thyroid eye disease: Towards an evidence base for treatment in the 21st century. Curr Neurol Neurosci Rep. 2012;12(3):318-324.
  26. Phelps P, Williams K. Thyroid eye disease for the primary care physician. Disease-a-Month. 2014;60:292-298.