Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
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Graves' ophthalmopathy, also called Graves' orbitopathy and now referred to asthyroid eye disease, is an autoimmune condition that usually develops in people with Graves’ disease.Graves' diseaseis a thyroid disorder that can cause serious eye problems as well.
In Graves’ ophthalmopathy, inflammation and swelling can affect muscles and other tissues around the eyes.
This article gives an overview of thyroid eye disease (Graves’ophthalmopathy), including symptoms, causes, diagnosis, and treatment.
1:33How the Thyroid Gland Works
1:33
How the Thyroid Gland Works
With thyroid eye disease, inflammation affects the muscles and other tissues around your eyes. This can cause your eyeballs to bulge, which is one of the most recognizable symptoms. This symptom is also calledexophthalmos, orproptosis.
Exophthalmos causes the eyes to feel achy and irritated, especially if your eyelids can’t close well to protect them.
Signs and symptoms of Graves’ ophthalmopathy include the following:
A 2020 review of research estimated Graves’ ophthalmopathy occurs in about 27% of people with Graves’ disease of the thyroid in the United States.In most cases, your immune system attacks the muscles and other tissues of the eye. Inflammation causes swelling and scarring.
Recap
If you have eye problems associated with Graves’ disease, you should see an ophthalmologist for a full eye exam.
Most symptoms of Graves’ ophthalmopathy can be treated successfully.Your ophthalmologist will help you determine treatment based on your symptoms.
Exophthalmos (Proptosis): What You Need to Know About Bulging Eyes
Medications
To minimizeeye irritation, your ophthalmologist may suggest using artificial tears several times daily. Ointments may be applied at night to prevent the eyes from drying out.
Steroids, such as prednisone, may be given to reduce swelling behind the eyes.
RecapMedications for thyroid eye disease may include artificial tears eye drops, ointments, steroids, and Tepezza (teprotumumab-trbw).
Medications for thyroid eye disease may include artificial tears eye drops, ointments, steroids, and Tepezza (teprotumumab-trbw).
Radiation
Orbital radiotherapy, or radiation, may be considered to treat inflammation around the eyes. You receive the treatment in an outpatient setting for up to 12 visits. Studies have shown that orbital radiotherapy and steroids are more effective than steroids alone.
Surgery
If your eyes are bulging, a surgeon may perform orbital decompression surgery. This procedure involves removing the thin bones that make up the orbit of the eye so that the eyes may move back to a more normal position.
This can relieve the pressure around your eyes, which is important for maintaining pressure in your eyes. High eye pressure can raise the risk of developingglaucoma.
Eye muscle surgerymay be performed if needed. Eyeglass prisms may be prescribed if the eye muscles are so swollen that the eyes can no longer be aligned properly.
Stop Smoking
If you smoke, quitting can help your treatment to be more effective. A review of research found that smokers had worse treatment outcomes for Graves’ ophthalmopathy than nonsmokers. Smokers were also more likely than nonsmokers to develop thyroid eye disease.
Summary
Thyroid eye disease (formerly Graves’ ophthalmopathy) causes inflammation affecting the muscles and tissues around your eyes. It can cause your eyes to bulge. You may also have double vision and eye irritation. Your ophthalmologist will suggest treatment to reduce symptoms and prevent further complications.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.McAlinden C.An overview of thyroid eye disease.Eye Vis (Lond). 2014;1:9. doi:10.1186/s40662-014-0009-8Kotwal A, Stan M.Current and future treatments for Graves' disease and Graves' ophthalmopathy.Horm Metab Res. 2018;50(12):871-886. doi:10.1055/a-0739-8134Chin YH, Ng CH, Lee MH, et al.Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review.Clin Endocrinol (Oxf). 2020;93(4):363-374. doi:10.1111/cen.14296Food and Drug Administration.Tepezza label.Rajendram R, Bunce C, Lee RW, Morley AM.Orbital radiotherapy for adult thyroid eye disease.Cochrane Database Syst Rev. 2012;(7):CD007114. doi:10.1002/14651858.CD007114.pub2Tabriz N, Gruben A, Uslar V, Weyhe D.Risk factors for Graves' orbitopathy in surgical patients-Results of a 10-year retrospective study with review of the literature.Endocrinol Diabetes Metab. 2020;4(1):e00210. doi:10.1002/edm2.210
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.McAlinden C.An overview of thyroid eye disease.Eye Vis (Lond). 2014;1:9. doi:10.1186/s40662-014-0009-8Kotwal A, Stan M.Current and future treatments for Graves' disease and Graves' ophthalmopathy.Horm Metab Res. 2018;50(12):871-886. doi:10.1055/a-0739-8134Chin YH, Ng CH, Lee MH, et al.Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review.Clin Endocrinol (Oxf). 2020;93(4):363-374. doi:10.1111/cen.14296Food and Drug Administration.Tepezza label.Rajendram R, Bunce C, Lee RW, Morley AM.Orbital radiotherapy for adult thyroid eye disease.Cochrane Database Syst Rev. 2012;(7):CD007114. doi:10.1002/14651858.CD007114.pub2Tabriz N, Gruben A, Uslar V, Weyhe D.Risk factors for Graves' orbitopathy in surgical patients-Results of a 10-year retrospective study with review of the literature.Endocrinol Diabetes Metab. 2020;4(1):e00210. doi:10.1002/edm2.210
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
McAlinden C.An overview of thyroid eye disease.Eye Vis (Lond). 2014;1:9. doi:10.1186/s40662-014-0009-8Kotwal A, Stan M.Current and future treatments for Graves' disease and Graves' ophthalmopathy.Horm Metab Res. 2018;50(12):871-886. doi:10.1055/a-0739-8134Chin YH, Ng CH, Lee MH, et al.Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review.Clin Endocrinol (Oxf). 2020;93(4):363-374. doi:10.1111/cen.14296Food and Drug Administration.Tepezza label.Rajendram R, Bunce C, Lee RW, Morley AM.Orbital radiotherapy for adult thyroid eye disease.Cochrane Database Syst Rev. 2012;(7):CD007114. doi:10.1002/14651858.CD007114.pub2Tabriz N, Gruben A, Uslar V, Weyhe D.Risk factors for Graves' orbitopathy in surgical patients-Results of a 10-year retrospective study with review of the literature.Endocrinol Diabetes Metab. 2020;4(1):e00210. doi:10.1002/edm2.210
McAlinden C.An overview of thyroid eye disease.Eye Vis (Lond). 2014;1:9. doi:10.1186/s40662-014-0009-8
Kotwal A, Stan M.Current and future treatments for Graves' disease and Graves' ophthalmopathy.Horm Metab Res. 2018;50(12):871-886. doi:10.1055/a-0739-8134
Chin YH, Ng CH, Lee MH, et al.Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review.Clin Endocrinol (Oxf). 2020;93(4):363-374. doi:10.1111/cen.14296
Food and Drug Administration.Tepezza label.
Rajendram R, Bunce C, Lee RW, Morley AM.Orbital radiotherapy for adult thyroid eye disease.Cochrane Database Syst Rev. 2012;(7):CD007114. doi:10.1002/14651858.CD007114.pub2
Tabriz N, Gruben A, Uslar V, Weyhe D.Risk factors for Graves' orbitopathy in surgical patients-Results of a 10-year retrospective study with review of the literature.Endocrinol Diabetes Metab. 2020;4(1):e00210. doi:10.1002/edm2.210
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