Endocrine Abstracts

Purpose: To evaluate the impact of thyroid eye disease (TED) on occupational disability and access to psychological input. Previous European studies have demonstrated a negative effect of TED on occupation but there are no similar UK studies.

Methods: 102 outpatients under the age of 75 were identified for participation from a joint thyroid eye clinic at a tertiary centre. 42 completed a standardised fixed-choice questionnaire about occupational disability and access to psychological therapies.

Results: 15% reported losing their job as a direct result of TED and 12% changed their jobs as they were deemed unfit for work. 44% had difficulty managing their job with 63% recording problems at work secondary to the physical impact of TED. 44% took time off work and this was due to double vision (39%), depression (34%), visual disturbances (39%), pain (24%), unsteadiness (22%) and appearance (14%).

44% of respondents accomplished less than they would have liked to at work and 44% were unable to focus due to low mood. 3% were currently undergoing or previously received psychological input, 8% reported that they would like to pursue psychological therapy. 15% reported being on anti-depressants prior to diagnosis of TED, and further 20% were started on antidepressants following diagnosis.

Conclusion: TED has a direct impact on patients’ vision resulting in stress and occupational impairment, including a significant number of patients suffering unnecessary job loss. This study confirms reports from other European countries (with higher rates of job loss in our study) and highlights the need for larger UK confirmatory studies, with a particular focus on occupational education and increasing understanding of the condition by employers and employees. Limited access to psychological therapies despite high levels of antidepressant use was also found, highlighting the importance of improving access to these services and increasing support for patients.