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Thyroid Eye Disease

Thyroid Eye Disease

Thyroid eye disease (TED) is an autoimmune condition that often occurs in people who develop an overactive thyroid gland. TED causes the fat and muscles behind the eye to enlarge. Symptoms include redness, irritation and pressure behind the eyes. This can push the eye forward and restrict its movement, resulting in the inability to fully close the eyelids. In some cases, protruding or misaligned eyes and double vision can occur.

CSC can effectively address the conditions caused by TED with medical management or by performing state-of-the-art eyelid, eye muscle or orbital surgery.


Through state-of-the-art vision testing, our physicians can diagnose your condition and recommend the most appropriate treatment based on your individual needs. Her treatment options include:

  • Topical ointments, artificial tears (preservatives are bad so stay away from that Visine) and topical anti-inflammatory drops
  • Topical, intranasal, oral, infusions behind the eye or intravenous corticosteroid treatment
  • Orbital radiotherapy
  • Removal of fat and sculpting of bone to restore the eye position (orbital decompression)
  • Eyelid retraction repair surgery to allow the eyelids to close
  • Eye muscle surgery to allow single vision
  • Eyelid skin debulking, fat sculpting
  • Skin resurfacing with topical products, peels and lasers

Thyroid eye disease (TED) is the most common cause of orbital inflammation and proptosis in adults, accounting for approximately 40% of all orbital disease. At least 80% of TED is associated with Graves disease (GD), one of the most common endocrine abnormalities in the world. Fifty to ninety percent of GD patients develop clinically evident, symptomatic, TED. GD and TED affect over 20 million previously healthy and productive adults in the United States alone. The peak incidence is in the fourth and fifth decades but may affect any race and any age.

Stabilization typically occurs in the second or third year but may be delayed in:

  • Men
  • Older patients (> 50 years old)
  • Cigarette smokers
  • Those with prolonged hypothyroidism or poorly controlled thyroid functions

Typical symptoms

  • Visual blurring and distortion
  • Double vision
  • Tearing
  • All of the above may interfere with driving, reading and computer use.

Typical signs:

  • Bulging eyes (proptosis)
  • Staring appearance (eyelid retraction causing more of the white of the eyes (sclera) to show)
  • Misaligned eyes from enlarged, restricted muscles behind the eyeball

TED can alter lives

  • Can result in visual disability
  • Can disfigure patients
  • Many TED patients are depressed, withdraw socially, lose self-esteem and suffer job dislocation, divorce and emotional devastation
  • The economic effect of this disease is great because it affects women, and less commonly men, in their peak years of productivity, impacting their families, communities and workplaces.

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