Approaches to the treatment of thyroid eye disease may vary, depending on the severity of associated symptoms and the extent of any complications. Mild thyroid eye disease that presents with minimal findings may only require treatment with supportive measures to relieve irritation. Patients who develop problems with excessive itchiness, redness, and foreign body sensations may use artificial tears applied as eye drops to provide lubrication. Patients who develop problems with exposure keratitis may need to take specific measures to protect their eyes from excessive drying that may occur while they sleep. Different approaches may focus on using protective eye shades to keep the eyes covered, taping both eyelids shut, or applying a special ointment at bedtime to protect the exposed surface of each cornea.
Moderate to severe thyroid eye disease that presents with significant proptosis, diplopia, or optic nerve compression may require specific treatment with medical therapy or surgery. Medical therapy usually focuses on using immunosuppressive therapy or external beam radiation to reduce inflammation and swelling in the tissues surrounding the eyeball. Surgery usually focuses on decompression of the enclosed space formed by the four walls of bone that make up the eye socket. This may help to relieve the pressure that contributes to protrusion of the eyeball, entrapment of extraocular muscles, or compression of the optic nerve. Surgery may also incorporate procedures targeted to correct problems with the alignment of the eyeballs and the positioning of the eyelids.