New Guidelines for Thyroid Eye Disease

22 July 2015

It is estimated that there are about 2,500 new cases of Thyroid Eye Disease (TED) every year in the UK. The figures have declined over the past 10-20 years for reasons that are unclear.

Nonetheless, far too often TED is undiagnosed for several months, or misdiagnosed as allergy or conjunctivitis, adding to the frustration of patients and denying them treatments that can make a difference. Simple, safe and low cost interventions early on can make a big difference. Selenium supplements, lubricant eyedrops, prisms, meticulous attention to controlling the thyroid, avoidance of radioactive iodine and smoking cessation, can prevent deterioration of the eye disease and improve quality of life.

In 2009 the European Group On Graves’ Orbitopathy (EUGOGO) spearheaded an international drive to improve the care of patients with TED. The Amsterdam Declaration for people with TED was signed by 84 national and international professional and patient-led organisations including the BTF, pledging to improve patient care. In the UK TEAMeD was born (Thyroid Eye Disease Amsterdam Declaration Implementation Group, www.btf-thyroid.org/index.php/campaigns/teamed) aiming to implement these objectives in the UK. In particular diagnosing TED early and getting patients to be seen in specialist centres was a high priority. And one way of achieving this is clinical guidelines.

TEAMeD embarked on this project three years ago and was able to secure support by the Royal College of Physicians as part of the College’s “Concise Guidance” series (1). After extensive deliberations between experts in endocrinology and ophthalmology and expert patients the guidelines were published in April 2015. They focus on four key areas: (a) criteria for early diagnosis of TED by GPs and endocrinologists (b) initiating simple, effective treatments as soon as the diagnosis is made (c) guidance on which patients should be referred to specialist centres and (d) empowering patients with Graves’ disease to recognise the early symptoms of TED, by use of a TED early warning card (http://www.btf-thyroid.org/images/stories/pdf/S5.pdf).

It is hoped that the guidelines will facilitate early diagnosis and better treatment of patients with this disfiguring disease.

To view the guideline visit http://www.clinmed.rcpjournal.org/content/15/2/173.abstract