Thyroid Eye Disease (TED) is a condition where the muscles, eyelids, tear glands, and fatty tissues behind the eyes become swollen and inflamed. This can make the eyes and eyelids red, swollen, and uncomfortable, and sometimes cause the eyes to bulge or have a “staring” appearance.
In some cases, the muscles that control eye movement become stiff and swollen, which makes it hard for the eyes to move together properly, leading to double vision. In rare cases, TED can reduce vision if the swelling presses on the nerve at the back of the eye or causes ulcers on the eye if the eyelids can’t close fully.
TED, also called Graves’ Orbitopathy or Ophthalmopathy, is an autoimmune disease, meaning the body’s immune system mistakenly attacks the tissues around the eyes, causing inflammation. For most people with TED, the same autoimmune reaction also affects the thyroid, often leading to Graves’ disease. Graves’ disease usually causes the thyroid to be overactive (hyperthyroidism), but it can also cause underactivity (hypothyroidism) in some cases. TED can occur whether the thyroid is overactive, underactive, or even functioning normally, and sometimes happens after treatment for Graves’ disease.
Thyroid Eye Disease (Graves' Disease)
Thyroid Eye Disease (TED), often linked to thyroid disorders like Graves’ disease, causes sore, red, and swollen eyes. More common in women, it leads to discomfort from irritated tissues around the eyes.
At Perfect Eyes Limited in London, we offer tailored treatments to manage TED and improve your eye health at any stage of the condition.
What is Thyroid Eye Disease (Graves' Disease)?
Causes of Thyroid Eye Disease
Autoimmune Reaction
TED happens because the immune system wrongly attacks the muscles and tissues around the eyes. This results in swelling and symptoms, including double vision or swollen eyes.
Thyroid Dysfunction
Thyroid eye disease is most common in people with thyroid issues, which usually causes an overactive thyroid. However, TED can also occur in people with an underactive thyroid or even normal thyroid levels.
Genetics
You have a higher chance of developing TED if you have family members with autoimmune or thyroid conditions. Your immune system’s response can be influenced by your genes.
Smoking
Smoking is a big risk factor. It makes TED more likely and can make the symptoms worse. This may be because smoking affects the immune system and reduces oxygen in the tissues.
Stress and Hormones
High stress or major hormone changes, like pregnancy or menopause, might trigger or worsen TED in people who are already at risk.
Radioactive Iodine Treatment
This is a common treatment for an overactive thyroid, but it can sometimes make TED worse. People who get this treatment are often given steroids to prevent eye problems from worsening.
Treatments for Thyroid Eye Disease
Thyroid Lid Lowering Surgery
Lid-lowering surgery is performed from within the eyelid to treat thyroid eye disease or eyelid retraction. This approach leaves no visible scars on the skin. The surgery is minimally invasive and is typically done as a day procedure, allowing for a quick recovery and minimal downtime.
Meet the Expert: Dr. Sabrina Shah-Desai
With over two decades of surgical and non-surgical experience, Dr. Sabrina Shah-Desai is currently considered to be one of the safest, most experienced oculoplastic surgeons in the UK. Her extensive training, in combination with her caring and empathetic nature, makes her a natural choice for patients seeking the very best care. For this reason, Dr. Sabrina Shah-Desai appears consistently in Tatler magazine as one of the UK’s “Best Eye Surgeon” and “Top Doctors” since 2019, and is the recipient of multiple awards, including “Best Aesthetic Doctor” Safety in Beauty Diamond Award 2023, “Consultant Surgeon of the Year”, “Best Surgical Result” Aesthetic Awards 2021 & Highly Commended “Consultant Surgeon of the Year” Aesthetic Awards 2022. She was voted by “MyFaceMyBody” as one of the Global 100 most influential aesthetic practitioners in 2019 & 2020.
Frequently Asked Questions
Can thyroid problems cause puffy eyes?
Yes, thyroid issues can cause puffy or swollen eyes. This condition is known as Thyroid Eye Disease (TED) or Graves’ Orbitopathy. In TED, the muscles and tissues around the eyes become swollen, causing the eyes to bulge forward. This can happen before, during, or after other signs of hyperthyroidism.
What are the first signs and symptoms of Thyroid Eye Disease?
Common early signs of TED include:
- Puffiness or bags under the eyes.
- Blurred or double vision.
- Bulging or “staring” eyes.
- Trouble moving the eyes.
- Dry, watery, or gritty eyes.
- Sensitivity to bright lights.
- Ocular pain, particularly when moving the eyes.
How serious is Thyroid Eye Disease?
The severity of TED varies from person to person. Some may only need lubricating eye drops for mild symptoms, while others may experience double vision or severe eye misalignment, requiring surgery.
How is Thyroid Eye Disease treated?
Treating thyroid problems doesn’t automatically fix TED, so additional treatments may include:
- Over-the-counter eye drops.
- Prescription medications.
- Quitting smoking.
- Lifestyle changes.
- Special eyeglasses.
- Eyelid surgery or orbital decompression surgery.
Can thyroid issues affect eyesight?
Yes, thyroid problems can impact your vision. Many people experience mild eye symptoms that improve as their thyroid condition is treated. However, some may continue to have eye issues, and in severe cases of Graves’ Orbitopathy, it can even lead to vision loss.
