Thyroid Eye Disease

Washington University orbital specialists offer focused diagnosis, management and treatment of Thyroid Eye Disease (TED).

Thyroid Eye Disease (TED) also known as Grave’s Eye Disease – is an immune-meditated inflammatory condition of eye and eye socket tissues, which can be associated with autoimmune thyroid disease. The target of orbital inflammation is the fibroblast, which stimulates enlargement of the tissues, fat proliferation and scarring.

TED can be treated with a steroid medication to control eye muscle swelling. TED surgery may be done to reposition the eye or the muscles of the eye, or to remove scar tissue or parts of the eye socket bone.

Risk Factors
  • TED is the most common eye socket disease in the United States, affecting 14 out of 100,000 people.
  • It is more common in women, especially 30-50 years old.
  • TED occurs in up to half of patients with thyroid disease, with less than 5% developing severe complications.
  • The disease typically develops within 18 months of developing hyperthyroidism.
  • It can occur in conditions with normal or low thyroid levels (less than 10%).
  • Dry, irritated or red eyes
  • Orbital protrusion (exophthalmos)
  • Eye misalignment (strabismus)
  • Wide-open eyes (eyelid retraction)
  • Overexposure of the eye
  • Inflammation and scarring of eye muscles
  • Eye restriction
  • Double vision
  • Corneal ulceration and vision loss (rare cases)
Evaluation and Diagnosis

An ophthalmologist, ideally an orbital specialist with experience in TED, should evaluate patients with autoimmune thyroid disease (especially hyperthyroidism) early in their symptoms. Not only is this important to prevent permanent vision loss, but also allows early introduction of newer treatment options, including Teprotumumab (Tepezza). History and clinical examination are the main diagnostic criteria, but lab testing can further clarify the diagnosis, especially for Thyroid Stimulating Immunoglobulin (TSI).

For appointments call:

Learn more about Oculofacial Plastic & Reconstructive Surgery