When Graves’ disease affects the eyes, the condition is known as thyroid associated ophthalmopathy (TAO) or thyroid eye disease. Graves’ disease usually appears before age 40.

Too much thyroid hormone along with circulating antibodies may cause the soft tissues and muscles that surround the eye to swell. Structures within the eye’s orbit — the bony space in which the eyeball sits — include muscles, blood vessels and nerves. When these structures swell within the enclosed space of the orbit, the eyes protrude or bulge. This may lead to problems moving the eyes, often resulting in double vision, one of the more common signs of thyroid ophthalmopathy.

Image reproduced, with permission, from Raab EL, Basic and Clinical Science Course, Section 6, American Academy of Ophthalmology, 2011-2012.

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