Managing thyroid eye disease

Thyroid eye disease, also called Graves’ eye disease, results from the effect of hyperthyroidism on the structures of the eyes. Hyperthyroidism occurs when the thyroid gland produces too much of the thyroid hormone. As a result, the body’s immune system attacks the eye muscles and tissues in the eye socket, causing swelling, inflammation and limited movement of the eye.1

There are four risk factors for thyroid disease:

  • Hyperthyroidism
  • Advanced age
  • Gender (more common in women)
  • Smoking

Approximately 1 million cases of Graves’ disease are diagnosed each year in the United States. Graves’ disease often occurs at the beginning of a person’s thyroid disease, and its active phase generally lasts 2 to 3 years. In some cases, the eye symptoms may appear before a diagnosis has been made.2 Up to 50 percent of all people with thyroid disease will experience Graves’ eye disease.3

Between 70 percent and 90 percent of patients with Graves’ disease have a distinctive protrusion or bulging of the eyes.1 Other symptoms include:

  • Dry, itchy, irritated eyes, especially in the initial stage
  • Swollen eyelids
  • Double vision, particularly when glancing down or up
  • Difficulty closing eyes completely, especially when sleeping
  • Vision loss

If you have Graves’ disease, your eye doctor will monitor your condition to preserve your sight, as well as to address discomfort from double vision and dry eyes.5 In rare cases, surgery may be required. While thyroid eye disease can cause permanent loss of vision due to pressure on the optic nerve, fewer than 5 percent of patients with Graves’ disease lose their sight.6

Like many other conditions, thyroid eye disease can be identified and treated early through regular comprehensive eye exams. Talk to your eye care professional or primary care doctor for more information about your risk for thyroid eye disease, particularly if you have a history of thyroid disorders.


1. University of Illinois at Chicago, “Eye Facts: Thyroid Eye Disease.” www.uic.edu/com/eye/LearningAboutVision/EyeFacts/ThyroidEyeDisease.shtml
2. Penn Eye Care Scheie Eye Institute, “Thyroid Eye Disease”
3. International Thyroid Eye Disease Society, “Who gets TED?” www.thyroideyedisease.org/who-gets-ted/
4. University of Michigan Kellogg Eye Center, “Graves’ eye disease or Thyroid eye disease,” www.kellogg.umich.edu/patientcare/conditions/graves.disease.html
5. Columbia University Medical Center Department of Surgery, New York Thyroid Center, “Thyroid Disorders: Thyroid Eye Disease”