Thyroid Disease Related Conditions An Overview of Thyroid Eye Disease By Troy Bedinghaus, OD linkedin Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association. Learn about our editorial process Troy Bedinghaus, OD Medically reviewed by Medically reviewed by Danielle Weiss, MD on August 10, 2020 linkedin Dr. Danielle Weiss is the founder of Center for Hormonal Health and Well-Being, a personalized, proactive, patient-centered medical practice with a unique focus on integrative endocrinology. She enjoys giving lectures and writing articles for both the lay public and medical audiences. Dr. Weiss is Assistant Clinical Professor of Medicine at the University of California, San Diego. Learn about our Medical Review Board Danielle Weiss, MD on August 10, 2020 Print Table of Contents View All Symptoms Causes Diagnosis Treatment People with thyroid disease sometimes develop an eye condition that causes the immune system to attack the muscles and other tissues around the eyes. This inflammation can cause the eyeballs to bulge from their sockets. Rarely, it can be severe enough to cause vision loss. There are many different names you might find for the autoimmune eye condition that is often seen in people with thyroid disease. These names include: Thyroid eye disease, sometimes abbreviated as TEDGraves' opthalmopathy (GO)Thyroid-associated orbitopathy (TAO)Grave's orbitopathy Illustration by Emily Roberts, Verywell Symptoms Thyroid eye disease can cause inflammation that may affect the muscles and other tissues around the eyes. Symptoms often include the following: Pain in the eyes when looking up, down, or sidewaysDryness, itching, dry eyes, difficulty wearing contact lensesInflammation and swelling of the eye and its surrounding tissuesSwelling of the orbital tissues which causes the eye to be pushed forward referred to as exophthalmos, which can make people with thyroid eye disease appear to have a wide-eyed or bulging, protuberant stare.Bloodshot eyesDouble vision (diplopia)Light sensitivityImpaired visionDifficulty moving the eyes Thyroid eye disease is known to go through varying degrees of severity and can go into periods of remission. It often lasts six months to two years. When it has been inactive for a period of around a half a year, it's less likely to recur. Causes Thyroid eye disease is an autoimmune eye condition that, while separate from thyroid disease, is often seen in conjunction with Graves' disease. About one in three people with Graves' disease have a mild form while five percent develop a severe form. The condition, however, is seen in people with no other evidence of thyroid dysfunction, and occasionally in patients who have Hashimoto's disease. Most thyroid patients, however, will not develop thyroid eye disease, and if so, only mildly. Smoking is associated with a worsening of symptoms. Diagnosis If you have hyperthyroidism and begin to experience symptoms involving your eyes, you should have a complete eye exam by an ophthalmologist. (If you have never had issues with your thyroid, a simple blood test will be ordered to check your thyroid levels.) Your doctor may find swelling and enlargement of the eye muscles. A CT scan or MRI scan of the eyes may be used to examine any swelling of the tissues behind the eye, in order to confirm the diagnosis. Treatment For a mild case, instill lubricating eye drops and artificial tears a few times during the day. Avoid wind and bright light. If you have severe symptoms, your doctor may prescribe corticosteroids such as prednisone to reduce swelling. In a very small percentage of patients, orbital decompression surgery may be recommended. This procedure removes the bone between the eye socket and the air sinus behind it so your eye has more room. This can improve your vision but there is a risk of double vision. Double vision can also occur when scar tissue from the ophthalmopathy makes an eye muscle too short. Eye muscle surgery can be used to attach the muscle at a point where it will again be the correct length to provide single vision. However, more than one surgery may be needed to be successful. A Word From Verywell If you are diagnosed with thyroid eye disease, be sure to wear sunglasses while in the sun. Your eyes will be more sensitive to the sun and wind and more vulnerable to ultraviolet rays. You may also try elevating the head of your bed to help relieve the pressure and swelling. Cool compresses may also help provide relief. Was this page helpful? Thanks for your feedback! Losing weight with thyroid disease can be a struggle. Our thyroid-friendly meal plan can help. Sign up and get yours free! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Estcourt S, Quinn AG, Vaidya B. Quality of life in thyroid eye disease: impact of quality of care. Eur J Endocrinol. 2011;164(5):649-55. doi:10.1530/EJE-11-0055 Maheshwari R, Weis E. Thyroid associated orbitopathy. Indian J Ophthalmol. 2012;60(2):87–93. doi:10.4103/0301-4738.94048 Bahn RS. Graves' ophthalmopathy. N Engl J Med. 2010;362(8):726–738. doi:10.1056/NEJMra0905750 Thyroid Eye Disease. American Society of Ophthalmic Plastic & Reconstructive Surgery. Giugni AS, Mani S, Kannan S, Hatipoglu B. Exophthalmos: A Forgotten Clinical Sign of Cushing's Syndrome. Case Rep Endocrinol. 2013;2013:205208. doi:10.1155/2013/205208 Thyroid Eye Disease. Cleveland Clinic. Burch HB, Cooper DS. Management of Graves Disease: A Review. JAMA. 2015;314(23):2544-54. doi:10.1001/jama.2015.16535 Barrio-barrio J, Sabater AL, Bonet-farriol E, Velázquez-villoria Á, Galofré JC. Graves' Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management. J Ophthalmol. 2015;2015:249125. doi:10.1155/2015/249125 Thyroid Eye Disease. Cleveland Clinic. Ismailova DS, Belovalova IM, Grusha YO, Sviridenko NY. Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review. Int Med Case Rep J. 2018;11:243-249. doi:10.2147/IMCRJ.S164372 Harrad R. Management of strabismus in thyroid eye disease. Eye (Lond). 2015;29(2):234-7. doi:10.1038/eye.2014.282 Additional Reading Baze, Elizabeth F., MD; David A. Weinberg, MD; Raymond S. Douglas, MD, PhD; Shivani Gupta, MD, MPH. "Thyroid Eye Disease." American Academy of Ophthalmology (AAO), 24 Mar 2014. Boyd, Kierstan. "What Is Graves Disease?" American Academy of Ophthalmology (AAO), 1 Sept 2017.