Surreal eye illustration representing thyroid eye disease

Eye Pressure & Thyroid Disease: What You Need to Know

Jordan Keane in Health & Wellness June 2025 • 4 min read.

"Exploring the Link Between Steroid Injections, Thyroid Eye Disease, and Intraocular Pressure"

Thyroid Eye Disease (TED), also known as Graves' ophthalmopathy, brings a range of challenges, not just to thyroid function, but also to eye health. Swelling around the eyes and even double vision can significantly affect quality of life. While corticosteroids are a primary treatment, concerns about side effects, like increased intraocular pressure (IOP), often arise.

Increased IOP, or ocular hypertension, is a major risk factor for glaucoma, a condition that damages the optic nerve and can lead to vision loss. Steroid-induced glaucoma is a known possibility, making it essential for both doctors and patients to carefully monitor IOP during TED treatment. This is where the use of intraorbital steroid injections comes into play as a localized treatment option aimed at minimizing systemic side effects.

A recent study published in the 'Journal of Thyroid Disorders & Therapy' investigated the effects of intraorbital steroid injections on IOP in patients with TED. By examining the records of individuals treated with these injections, the researchers sought to determine whether this method significantly impacts IOP. Let's explore the study's findings and what they mean for managing TED.

Does Orbital Steroid Injection Influence Eye Pressure?

Surreal eye illustration representing thyroid eye disease

The study, led by Vladimir S. Yakopson and colleagues at the Wills Eye Institute, reviewed the clinical records of 56 patients with active TED who underwent orbital steroid injections. The goal was to analyze changes in IOP following these injections. The study included 51 females and 5 males, with an average age of 50 years. These patients received an average of 3.5 injections each, using a combination of dexamethasone with either betamethasone, methylprednisolone, or triamcinolone.

Key measurements were taken to assess the impact of the injections: pre-injection IOP, post-injection IOP, and IOP changes over the long term. Researchers also tracked subjective improvements, such as reduced swelling and changes in diplopia (double vision). Here’s a breakdown of the key findings:

No Significant IOP Increase: The study found no statistically significant increase in IOP following orbital steroid injections. In fact, the mean IOP tended to be slightly lower after the injections.
Short-Term vs. Long-Term Effects: There was no significant difference between pre- and post-injection IOP (short-term effect) or between the first and last recorded IOP (long-term effect).
Subjective Improvements: Many patients reported improvements in swelling. Specifically, swelling was reduced in 63% of cases. Diplopia improved in 76% of patients who reported this symptom.

These results suggest that, in this particular study group, orbital steroid injections did not lead to a clinically significant increase in IOP. This is an important finding, as it provides evidence that localized steroid injections might be a viable option for managing TED without necessarily elevating the risk of glaucoma.

What Does This Mean for TED Treatment?

While the study offers reassuring evidence, it is essential to remember that every patient is unique, and potential risks should always be carefully weighed against potential benefits. Regular monitoring of IOP remains a crucial part of managing TED, especially when using steroid treatments. If you're considering orbital steroid injections, discuss the potential risks and benefits with your ophthalmologist or endocrinologist to determine the best course of action for your specific situation. This study adds valuable information to the ongoing discussion about effective and safe TED management, reinforcing the need for personalized treatment approaches.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4172/2167-7948.1000173, Alternate LINK

Title: Effect Of Intraorbital Steroid Injections On Intraocular Pressure In Thyroid Eye Disease

Subject: Psychiatry and Mental health

Journal: Journal of Thyroid Disorders & Therapy

Publisher: OMICS Publishing Group

Authors: Vladimir S Yakopson Jacqueline R Carrasco

Published: 2014-01-01

Everything You Need To Know

How does Thyroid Eye Disease (TED) impact eye health, and why is there concern about increased eye pressure during treatment?

Thyroid Eye Disease (TED), also known as Graves' ophthalmopathy, impacts eye health and can cause swelling around the eyes and double vision, affecting quality of life. While corticosteroids are a primary treatment for TED, there are concerns about side effects such as increased intraocular pressure (IOP). High IOP is a risk factor for glaucoma, a condition that can damage the optic nerve and lead to vision loss. Intraorbital steroid injections are used as a localized treatment to minimize systemic side effects and reduce the risk of elevated IOP.

What did the study conducted by Vladimir S. Yakopson reveal about the impact of orbital steroid injections on eye pressure in Thyroid Eye Disease (TED) patients?

A study by Vladimir S. Yakopson and colleagues at the Wills Eye Institute examined the effects of intraorbital steroid injections on intraocular pressure (IOP) in 56 patients with active Thyroid Eye Disease (TED). The study found no statistically significant increase in IOP following these injections. The mean IOP tended to be slightly lower after the injections, indicating that localized steroid injections might be a viable option for managing TED without necessarily elevating the risk of glaucoma.

What were the specific outcomes of the study regarding short-term and long-term intraocular pressure (IOP) changes and subjective improvements in Thyroid Eye Disease (TED) patients receiving orbital steroid injections?

The key findings of the study indicated that there was no significant difference between pre- and post-injection intraocular pressure (IOP), representing the short-term effect. Furthermore, there was no significant difference between the first and last recorded IOP, reflecting the long-term effect. Subjectively, many patients reported improvements in swelling (63% of cases) and diplopia (double vision) improved in 76% of patients who reported this symptom. These results suggest that orbital steroid injections did not lead to a clinically significant increase in IOP within this study group.

What precautions should be taken when considering orbital steroid injections for Thyroid Eye Disease (TED), even if the study suggests a minimal impact on intraocular pressure (IOP)?

Although the study provides reassuring evidence that orbital steroid injections may not significantly increase intraocular pressure (IOP), it is vital to recognize that each patient is unique. Regular monitoring of IOP remains essential, particularly when using steroid treatments. It is always important to discuss the potential risks and benefits of orbital steroid injections with your ophthalmologist or endocrinologist to determine the best course of action for your specific condition. The study reinforces the importance of personalized treatment approaches in managing Thyroid Eye Disease (TED).

What is glaucoma, and what are the potential implications of steroid-induced glaucoma in the context of Thyroid Eye Disease (TED) treatment?

Glaucoma is a condition that damages the optic nerve, often associated with increased intraocular pressure (IOP). Steroid-induced glaucoma is a known risk when using corticosteroids for conditions like Thyroid Eye Disease (TED). While the study mentioned suggests orbital steroid injections may not significantly increase IOP, consistent monitoring and personalized treatment approaches are crucial to mitigating this risk and preserving vision. Untreated glaucoma can lead to progressive and irreversible vision loss.