Thyroid eye disease, also called TED or Grave’s disease, is an autoimmune system illness where immune cells attack the thyroid gland resulting in excess secretion of the thyroid hormone. This causes the gland to enlarge, leading the excess hormones to increase metabolism. The increased metabolic state can cause heart palpitations, high blood pressure, loss of hair, and many more harmful side effects. When the immune system begins to attack the eyes, it can force the eye muscles and fat to expand. 10-20% of patients deal with sight loss, which is why it is crucial to see a doctor once symptoms present themself.

Signs & Symptoms

Because the eye is being attacked, the body responds with pain and swelling, which typically results in the following:

  • Pain
  • Red in the whites of your eyes
  • Double vision
  • Unusually dry or watery eyes
  • Puffiness around and surrounding the eyes
  • Bulging of the eyes
  • Irritation and dry eye, caused by the inability to close eyes due to bulging

With continuing, swelling results in:

  • Pressure on the socket
  • Restrictions in the movement of the eyes cause double vision

Since the muscles around the eye are particularly susceptible, they may begin to lose their ability to stretch, resulting in double vision or a “staring” effect. When these symptoms start to present themselves, patients fear vision loss, but fortunately, a tiny percentage of patients with TED lose their vision.

Causes & Risks

The disease begins when your immune system confuses your tissue for a foreign invader and begins attacking it. Currently, researchers are unsure of the cause. However, over one million Americans are diagnosed with thyroid eye disease each year. Women are 5 to 6 times more likely to develop the disease, and smokers are at an increased risk of developing the disease and have more severe effects. It also has to do with genetics. Those with hyperthyroidism tend to be far more susceptible to development.


While the disease cannot be prevented, it can be treated. Treatment is typically done in two phases.
Treating the active disease- This typically lasts two to three years focusing on preserving sight and the cornea. Patients usually find ways to deal with the discomfort of dry eyes with drops, taping eyes closed when sleeping, and medications like prednisone for temporary relief. Another course of treatment is radiation therapy, where most patients find comfort in just two months. However, this can only be done so many times not to increase the risk of tumors and the effects of ocular dryness. Surgical decompression is also used in the active phase, causing relief from congestion, pain, and ocular exposure.
Keeping the disease at bay is typically a continuous effort to keep the eye healthy and working properly. It can entail surgery to place the eye back to its original position. It is essential to focus on health, including quitting smoking, to reduce the severity and focus on the health of your body and eyes.

Because symptoms can be mild, patients are not always quick to connect the dots. Therefore, it is crucial to have your thyroid levels checked at your yearly physical given by your primary doctor. If your levels come back high, contact the Center for Diabetes and Endocrine Care for diagnosis and course of treatment. Don’t let your symptoms run your life, get help now.