A common health problem that often affects those with Graves’ disease is thyroid eye disease (TED), also called Graves’ eye disease, Graves’ ophthalmopathy, or thyroid ophthalmopathy.

Graves’ disease occurs when your antibodies attack your thyroid gland. Your thyroid responds by making more thyroid hormone than your body needs (called hyperthyroidism). This has body-wide effects because thyroid hormone is responsible for how your entire system uses energy.

Symptoms of an over-active thyroid include a racing heart, heart palpitations, high blood pressure, sweating too much, fatigue, intolerance to heat, hair loss, weight loss, and more.

In TED, along with attacking your thyroid, your immune system also attacks your eye muscles and their connective tissues.

Hyperthyroidism is often confused with hypothyroidism, and the eyes are only a concern if you have hyperthyroidism – an overactive thyroid due to Graves eye disease.

TED is not a complication of Graves’ disease, but the two are related because they often occur at the same time. This may be because the thyroid tissues and the eye tissues are made up of proteins that look similar to your immune system.

The symptoms and treatment options for thyroid eye disease are discussed in further detail below.


Your Thyroid and Your Eyes: Symptoms and Treatment of TED


Bulging Eyes

TED can cause a number of symptoms. However, one of the most tell-tale signs of the disease is bulging or staring eyes. You’ll see this in lots of Graves’ disease pictures that illustrate how the illness manifests physically.

The reason bulging eyes occurs is that TED causes inflammation of the muscles and tissues behind the eyes. As a result, they may be pushed forward. In addition, the eyelids and eyes themselves can become red and inflamed.


Other TED Symptoms

Other symptoms may include dry eyes, watery eyes, sensitivity to light, a gritty feeling in the eyes, bags under the eyes, swelling in the upper eyelids, pain in or around the eyes, and blurred vision.

Pain often happens because the inflammation can cause pressure to build up inside your eye socket. Additionally, vision problems occur because the inflammation can put pressure on your optic nerve.


How Is Thyroid Eye Disease Treated?

TED is generally treated in two stages. The first addresses the inflammation, pain, and other symptoms. Of course, this is assuming that your thyroid hormone is back under control and at normal levels, first.

The second stage of TED treatment addresses the physical changes that may have occurred.

  • Eye drops, eye gels, or an eyelid spray can provide relief from the burning, stinging, itching, and dryness that can come from TED.
  • Many people with TED have eyes that bulge so much that they can’t close their eyelids over the entire eye. These people often use eye gel at night to keep their eyes lubricated.
  • To relieve pressure on the eyes, many people with TED sleep with their heads elevated at night. Cool compresses can additionally help with swelling and irritation.
  • For people with excessive swelling, steroid treatment is another option.
  • Decompression surgery may be helpful for relieving pressure behind the eyes or pressure on the optic nerve.

The inflammation associated with TED can take up to a few years to resolve. After this time, you may still have bulging eyes or eyelids that don’t completely cover the eye surface. Many people elect for surgery to get back to looking more normal and to help their eyes function the way they should.

  • Orbital decompression surgery can help the eyes return to a more normal position in the eye socket.
  • Eyelid surgery can improve the appearance and function of the eyelids.
  • Eye muscle surgery can improve or correct double vision that came about because of inflammation.


Can Thyroid Eye Disease Be Prevented?

You cannot prevent TED or Graves’ disease, but there are some ways to lessen your risk factors.

If you smoke, in particular, you have a much higher chance of developing the disease. Meanwhile, if you contract the disease and you smoke, the severity of your symptoms will be much worse. Anyone who smokes cigarettes should take the necessary steps to quit to lessen their risk of developing or worsening TED.

If you have Graves’ disease or hyperthyroidism, it’s also essential that you get your thyroid levels under control and keep them that way. You should regularly check in with a doctor for blood tests and take your medication.

It’s equally important to see an eye doctor regularly. They can monitor your eye health and treat signs and symptoms of TED before they become huge issues. This is especially true if you have Graves’ disease.

TED isn’t preventable, but there are ways to treat the disease, so you can live life normally. If you experience any symptoms, the key is to see your eye doctor as soon as possible.

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