Thyroid Eye Clinic
The thyroid eye clinic is a regional referral service for the assessment of patients with thyroid eye disease. Most patients attending the clinic come from Lothian but we also have patients from Fife and Borders. It was set up in May 2010 and runs weekly
Opthalmology: Dr Brian Fleck and Dr Ida Boron (specialty doctor)
What is the thyroid gland?
The thyroid is a butterfly shaped gland situated in the front of the neck, just below the Adam’s apple, and is responsible for producing thyroid hormones (T4 and T3). Thyroid hormones help control metabolism and health problems can occur if the gland produces too much or not enough hormone. One of the common forms of overactive thyroid disease (Graves' disease), is caused by the body’s own immune system making antibodies, which attack the thyroid gland and make it go overactive
What is thyroid eye disease?
The same antibodies that cause Graves' disease can also attack the tissues behind the eye, leading to thyroid eye disease. The common symptoms include a change in the appearance of the eye, redness or swelling of the eyes or eyelids and pain in the eyes. The eyelids can also become drawn back, giving a staring appearance to the eyes. Thyroid Eye Disease is also sometimes referred to as TED, Graves' Eye disease, Graves' Orbitopathy or Dysthyroid Eye Disease. Although TED most often occurs in association with an overactive thyroid, it can also occur with a normal or underactive gland.
Why have I been referred to this clinic?
European guidelines from a group called EUGOGO (European Group on Graves' Orbitopathy) suggest that anyone who has more than just mild TED should be seen in a combined clinic by thyroid specialists (endocrinologists) and eye specialists (ophthalmologists). Your GP, endocrinologist or ophthalmologist will have decided that it would be best for your eyes if you were seen in this joint clinic, where we can look at all aspects of the condition in a single appointment.
The TED clinic also has close links with other specialists who provide some of the treatments that may be needed for TED, including:
- Drs Jan Kerr and Mark Wright: oculoplastic surgeons who undertake eye lid surgery
- Drs Gillian MacDougall and Iain Hathorne: ENT surgeons who undertake orbital decompression surgery
- Dr Sara Erridge: Clinical oncologist who oversees orbital radiotherapy
What will happen at this clinic?
You will be seen by both thyroid and eye doctors. When you first arrive in clinic you will usually be seen by a nurse who will do some initial assessments of your eyesight. Unless you have had a blood test done recently, blood will be taken by the nurse at your first appointment. For future appointments, we will usually ask you to have a blood test with your practice nurse just before your clinic appointments so that we can give you your results and act on them at your appointment. You may also be seen by the orthoptist on some appointments if a detailed assessment of your eye movements is needed. We may also take a photograph of your eyes so that we can look back later and have a better idea of how your eyes have improved with treatment.
Various treatments may be offered in the clinic, including eye lubricants, advice on smoking cessation, selenium supplements, steroids, other medication to target the immune system, radiotherapy and surgery.
We will give you information on TED in the clinic, but you may also find these links useful:
- British Thyroid Foundation
- British Thyroid Foundation Eye Disease Guide
- Thyroid Eye Disease charitable trust (TEDct)
- Information on the effects of smoking on TED
- Information on the role of a supplement called selenium in TED