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Thyroid Eye Disease

Graves Disease

Definition of
Thyroid Eye Disease (TED)

Thyroid eye disease, also known as Graves’ ophthalmopathy or Graves’ orbitopathy, is an autoimmune disorder that affects the eyes and is commonly associated with an overactive thyroid gland (hyperthyroidism). It occurs when the immune system mistakenly attacks the tissues and muscles around the eyes, leading to inflammation and swelling.

risk factors for Thyroid Eye Disease (TED)


Proptosis (Bulging Eyes)

One of the hallmark symptoms of TED is the protrusion or bulging of one or both eyes. This occurs due to inflammation and swelling of the tissues behind the eyes, pushing them forward.

The tissues around the eyes, including the eyelids, can become red, swollen, and puffy. This can give a “staring” or wide-eyed appearance.

TED can cause discomfort and irritation in the eyes, including a gritty or sandy feeling, itching, and burning sensations. The eyes may also feel dry and become easily irritated.

TED can lead to double vision, where a person sees two images of a single object. This occurs due to the misalignment of the eyes caused by the inflammation and swelling of the eye muscles.

Some individuals with TED may experience pain and pressure behind the eyes. This can be worsened by eye movements or when looking in certain directions.

The eyes may become more sensitive to light, causing discomfort and a need for sunglasses or dim lighting.

In severe cases, TED can restrict eye movements, making it difficult to move the eyes in certain directions. This can contribute to double vision and affect daily activities such as reading or driving.

TED can lead to incomplete or difficulty in fully closing the eyes, especially during sleep. This can cause dryness and increased risk of corneal damage.

TED can affect vision in various ways, including blurry vision, reduced visual acuity, and in severe cases, vision loss.

Thyroid eye disease (TED), also known as Graves’ ophthalmopathy or Graves’ orbitopathy, can cause a range of symptoms that vary in severity from person to person. The symptoms of TED primarily affect the eyes and surrounding tissues.

treatment types


For mild cases of TED, observation and monitoring of symptoms may be recommended. This involves regular visits to an ophthalmologist to assess the progression of the disease and determine if any treatment is necessary.

Medications such as corticosteroids, immunosuppressants, and biologic agents may be prescribed to manage inflammation and reduce swelling in the eyes. These medications are typically administered orally or through injection.

Artificial tears or lubricating eye drops may be recommended to alleviate dryness and discomfort in the eyes.

 Prism glasses may be prescribed to help correct double vision caused by TED. These glasses contain special lenses that bend light and help to align the images seen by each eye.

In severe cases of TED, surgery may be necessary to correct eye protrusion, improve eyelid position, or relieve pressure on the optic nerve. Surgery may involve decompression of the eye socket or correction of eyelid position.

If the individual with TED is a smoker, smoking cessation is highly recommended. Smoking has been associated with a higher risk of developing TED and can worsen the severity of symptoms.

It is important to note that not all individuals with TED will experience all of these symptoms, and the severity of symptoms can vary. If you suspect you may have (TED) or are experiencing any of these symptoms, it is important to consult with a healthcare professional, preferably an ophthalmologist, for proper evaluation and management.

Frequently Asked Questions

What is thyroid eye disease (TED)?

Thyroid eye disease, also known as Graves’ ophthalmopathy or Graves’ orbitopathy, is an autoimmune condition that affects the eyes and surrounding tissues. It is commonly associated with an overactive thyroid gland (hyperthyroidism) caused by Graves’ disease.

The symptoms of TED can vary, but commonly include bulging or protruding eyes (proptosis), redness and swelling of the eyes, eye discomfort or pain, double vision (diplopia), dryness and irritation of the eyes, difficulty closing the eyes completely, and changes in vision.

TED can range from mild to severe, and in severe cases, it can lead to vision loss or permanent eye damage. It is important to seek medical attention if you suspect you have TED to prevent complications and manage the condition effectively.

Yes, thyroid eye disease can be treated. The treatment options depend on the severity of symptoms and may include medications to reduce inflammation, artificial tears to alleviate dryness, prism glasses to correct double vision, and in severe cases, surgery to improve eye position or relieve pressure on the optic nerve.

In some cases, mild symptoms of TED may improve or even resolve on their own without treatment. However, it is important to monitor the condition closely and seek medical advice to ensure proper management and prevent complications.

There is no guaranteed way to prevent thyroid eye disease. However, managing underlying conditions such as Graves’ disease and maintaining a healthy lifestyle, including not smoking, may help reduce the risk or severity of TED.

In some cases, thyroid eye disease can recur or worsen even after treatment. Regular follow-up visits with healthcare professionals are important to monitor the condition and adjust treatment if needed.

Yes, thyroid eye disease can affect one or both eyes. In most cases, both eyes are eventually affected, but the severity of symptoms can vary between the eyes.

While there is no known cure for thyroid eye disease, proper management and treatment can help control symptoms, prevent complications, and improve quality of life. With appropriate care, many individuals with TED can achieve good outcomes and symptom control.