Road to Recovery with Thyroid Eye Disease Care

Have you noticed your eyes appearing puffy or protruding lately? You may be suffering from a condition called thyroid eye disease. Here at Eagle Aesthetics & Surgery, we can help you manage this condition.

What is Thyroid Eye Disease (TED)?

Thyroid eye disease, also known as Graves’ ophthalmopathy or TED, is a condition where the tissues around the eyes become inflamed and swollen. This includes muscles, fatty tissues and connective tissues in the eye area.

It is considered an autoimmune disorder, meaning the immune system mistakenly attacks the body’s own tissues. Thyroid eye disease is often linked to Graves’ disease, another autoimmune condition that causes the thyroid gland to work too actively. However, thyroid eye disease can also affect people without Graves’ disease. 

There are two phases of Thyroid Eye Disease – the active/inflammatory phase, and the stable phase

Active/Inflammatory Phase

  • Occurs in the initial months/years after symptoms first appear.
  • Characterised by swelling and inflammation in the extraocular muscles and orbital tissues surrounding the eyes.
  • Symptoms can worsen rapidly.
  • Eye bulging, eyelid retraction and corneal issues tend to be most severe.
  • Double vision, eye pain/soreness and blurry vision are also common

If untreated, the active phase can last 18-24 months on average but sometimes persists longer.

Stable Phase

  • Begins after the initial inflammatory changes have stabilised, usually 1-3 years after symptoms start.
  • Disease process is no longer actively progressing.
  • Symptoms such as double vision, eyelid issues and eye bulging may still cause problems.
  • Management of the condition focuses on addressing lingering issues rather than suppressing inflammation.

Recurrence of active inflammation is possible with major life stressors or if thyroid disease becomes unstable again.

Symptoms of Thyroid Eye Disease

The signs and symptoms of thyroid eye disease include:

  • Dry, gritty, irritated eyes
  • Watery & red eyes
  • Bulging eyes (proptosis)
  • Double vision (diplopia)
  • Difficulty closing your eyes completely
  • Pain at the eyes with movement

While symptoms normally affect both eyes, sometimes symptoms may only be noticed in one eye.

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Treating Thyroid Eye Disease

Treating thyroid disease does not treat thyroid eye disease, hence additional management for the symptoms may be recommended by your doctor. Mild thyroid eye disease may resolve by themselves, while more severe cases of thyroid eye disease may require a oral medication, surgery, or a combination of the two.


  • Over-the-counter eyedrops for dryness and itchiness of the eyes
  • Quit smoking. Smoking can exacerbate symptoms and may even decrease effectiveness of treatment
  • Use cool compress over the eyes to relieve discomfort
  • Wear special glasses or patch to alleviate double vision

Prescription medication

  • Corticosteroids to reduce inflammation during the active phase
  • Monoclonal antibodies that targets B lymphocytes involved in the autoimmune response
  • Teprotumumab, a newer monoclonal antibody treatment specifically approved for thyroid eye disease, which targets the IGF-1R receptor involved in the development of the condition


  • Eyelid surgery: Surgery to the eyelids can be done to correct misaligned lids. This reduces exposure of the cornea to prevent further damage.
  • Eye muscle (Strabismus) surgery: Your oculoplastic doctor may recommend surgery to realign your eye muscles to help correct double vision. 
  • Orbital decompression surgery: This surgery relieves the pressure on the optic nerves by enlarging the eye socket larger or taking away excess swollen tissue. The surgery is usually done first before other surgeries for thyroid eye disease.
  • Radiation: Your oculoplastic surgeon may suggest radiation therapy to further suppress the inflammation of thyroid eye disease.

Thyroid levels must remain stable to prevent exacerbations. Lifelong monitoring of thyroid and eye status is often required.

Frequently Asked Questions

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