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  • A woman with eyelid retraction and eye bulge, which are common symptoms of thyroid eye disease

    What Is Thyroid Eye Disease (TED) or Graves' eye disease?

    Edited By David Turbert
    Published Jun. 15, 2023

    The thyroid is a gland in the front of your neck. It makes hormones that help control your metabolism.

    Thyroid Eye Disease (or TED, also known as Graves’ eye disease) is an autoimmune condition. It happens when the thyroid gland is not working the way it should.

    When most people get TED, the thyroid gland makes too much hormone. But others with TED have too little hormone or a normal amount.

    With TED, the immune system attacks the muscles and tissues surrounding the eyes.

    Who Is At Risk for Thyroid Eye Disease (TED) or Graves' Eye Disease?

    While anyone can get TED (or Graves' eye disease), it is more common in:

    • smokers
    • those with a family history of the disease

    What Are the Symptoms of Thyroid Eye Disease (TED) or Graves' Eye Disease?

    Symptoms of TED (or Graves' eye disease) can vary and may come and go. Here are some of them:

    • Eye protrusion. TED can cause the muscles in and around the eye to swell and push the eye forward. This eye bulge makes someone look as if they are constantly staring.
    • Eyelid retraction. With the eye pushed forward, the upper and lower eyelids retract (pull back). This makes the white part of the eye more visible.
    • Dry eye. With TED, the eyes are more exposed to wind and dust. This can make the eyes very dry. Dry eye makes the eyes feel scratchy and uncomfortable, and makes vision blurry. Being very sensitive to light is also a problem.
    • Vision changes. Muscle swelling can cause double vision (seeing two images of the same object). Swelling can also pressure and damage the optic nerve (the part of the eye connecting the eye to the brain), which can lead to vision loss.
    • Eye “bags.” When the eyelid swells, it can cause tissue around the eye to bulge. This looks like bags around the eyes, and can make someone look older than they are.

    How Is Thyroid Eye Disease (TED) or Graves' Eye Disease Treated?

    Home remedies and lifestyle changes:

    • Use artificial tears or lubricating ointment to relieve dry eyes
    • Wear sunglasses to help with light sensitivity.
    • Apply cool compresses on the eyes to reduce irritation and swelling.
    • Quit smoking, as it can make symptoms worse
    • Reduce stress with regular exercise

    If your TED (or Graves' eye disease) symptoms worsen, you may need medication or surgery.

    Medication:

    • Steroid medicine to control eye muscle swelling.
    • Teprotumumab-trbw. Given by infusion (put in body through a vein), this medication reduces TED symptoms and may eliminate the need for eye muscle surgery. If this medication is right for you, your doctor will explain how often treatment is needed.

    If you have double vision, your doctor may prescribe special eyeglasses with prism correction to restore normal vision.

    Surgery

    TED surgery may be done to reposition the eye or the muscles of the eye, or to remove scar tissue or parts of the eye socket bone. Surgery can:

    • Fix eyelid retraction, relieve dry eye and improve the appearance of the eyes.
    • Help improve vision and bulging eyes
    • Help the eye muscles work better.
    • Push the eye back into a more normal position
    • Relieve pressure on the optic nerve to prevent vision loss.