What tests are performed in patients with TED?

It cannot be emphasised too strongly how important it is that patients with TED see an eye specialist who has a special interest and expertise in the disease.

Specific tests are needed in TED in order to fully assess the state of the eyes and the thyroid status. These may include:

• Re-check of thyroid function
• Visual acuity (Checking sight using a vision chart)
• Assessment of eyelid position and function
• Assessment of the eye position within its bony socket, the orbit (exophthalmometry)
• Slit lamp (microscopic) examination of the surface the eye, particularly the cornea
• Pupil testing (a test of optic nerve function)
• Test of eye pressures (intraocular pressure, also known as IOP)
• Colour vision testing (a sensitive test of optic nerve function)
• Examination of the back of the eye, in particular the optic nerve where it enters the eye (this corresponds to the 'blind spot')
• Eye movement assessment (possibly with an orthoptist who specialises in eye movement testing)

Field of vision test ('a field test', for example with a Humphrey machine)
CT or MRI of orbits (specialised X-ray or scans to look at the tissues around the eyes)

Enlarged muscle on left side compared to the right on an MRI scan

• Ultrasound scan of the eye muscles
• Visual evoked responses to detect optic nerve damage (rarely used)