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What happens during Thyroid Eye Disease?

When you have TED, your immune system mistakenly attacks the muscle and fat tissue behind your eyes, causing inflammation (redness and swelling) and scar tissue to form. It was once thought that TED has two phases known as an “acute” or “active” phase and a “chronic” or “inactive” phase. You may have even heard these terms from your doctor. However, newer research shows that TED changes over time, with symptoms that can appear anytime and range from mild to severe, making it difficult to diagnose.

Learn what is happening to your eyes with TED

Thyroid Eye Disease (TED) and Graves’ disease are both autoimmune disorders. While TED often develops in people who have Graves’ disease, they are different conditions. That’s why they require different treatments.

Graves’ disease affects the thyroid. TED affects the muscle and fat behind the eyes. Watch the video below to learn more about the differences between TED and Graves’ disease, and TED risk factors.

  • Read transcript

    Announcer: Thyroid Eye Disease (or TED) is a rare disease affecting the eyes. TED is also referred to as Graves’ Eye Disease. TED can develop in patients with Graves’ disease. Although they are both autoimmune conditions, TED and Graves’ disease are different conditions as they affect different parts of the body. 

    In Graves’ disease, the body mistakenly attacks the thyroid glands, resulting in an overactive thyroid, or hyperthyroidism. In TED, the immune system attacks the muscles and fat tissues behind the eyes, causing redness and swelling known as inflammation. This process results in both the muscles and fat tissues behind the eyes expanding, as well as a buildup of fluid. 

    Treatments for Graves’ disease are targeted to help the thyroid but won’t help TED. Different medications and specialists are required to manage each condition. Some of the early symptoms of TED are eye pain, redness, dry or gritty eyes, or overly watery eyes, and blurry vision. These symptoms can be mistaken for other conditions, such as allergies. 

    TED is a progressive disease, which means it can get worse over time. Bulging eyes and eyelid swelling may occur as TED progresses. Eye swelling can make it hard to move the eyes. All these effects can lead to vision impairment, including double vision. In some cases, it is possible for swelling of fat and muscle tissue to push against the optic nerve, which puts vision at risk. 

    While it is not entirely known why some people develop TED and others do not, doctors have found certain factors that put people at greater risk. This includes having a thyroid condition such as Graves’ disease or hyperthyroidism, and Hashimoto’s disease, or hypothyroidism. The risk of developing TED may also be increased if patients have received radioactive iodine as treatment for Graves’ disease. In general, women are more likely to suffer from TED. Smoking and middle age further increase the risk of developing the condition. 

    As a rare and complicated disease, TED treatment requires a specialist who is familiar with treating it. Doctors who are most familiar with TED are usually specialized ophthalmologists, such as oculoplastic surgeons, neuro-ophthalmologists, and strabismus surgeons. Remember, TED can get worse over time. Getting treatment as early as possible can help prevent further eye damage. 

    Find a TED Eye Specialist at TEDdoctors.com

What is happening to the eye during TED

When you first develop Thyroid Eye Disease, you may notice changes in symptoms

What are the early signs and symptoms of Thyroid Eye Disease?

You may notice these changes that can affect your appearance and visual function:

  • Redness
  • Swelling
  • Dry, gritty eyes
  • Eye bulging
  • Double vision
  • Misaligned eyes or eyes that don’t work
    together
  • Sensitivity to light
  • Eye pain and pressure

The changes that TED causes to your eyes can impact you emotionally, making you feel anxious or depressed. You can use this tool to help have a conversation with your doctor about all the ways TED impacts your life.

Learn more about the symptoms and signs of TED as well as the impact it can have on your emotional well-being.

Does Thyroid Eye Disease go away?

Thyroid Eye Disease signs and symptoms may decrease over time, but that does not mean it goes away. It can change over time, making it difficult to diagnose. TED affects everyone differently, which is why symptoms can appear at any time and feel or look differently with each person.

Over time, inflammation can cause scar tissue to build up. If left untreated, this can cause damage to the eyes, and extend or prolong the symptoms.

Early treatment can help prevent damage, but treatment later in the course of TED may still help.

The longer that TED goes untreated, the more likely it is for serious damage to happen to your eyes. While starting treatment as soon as possible is recommended to prevent further damage, patients who have had symptoms of TED for years may also benefit from treatment.

Learn about a treatment option for TED.

Having TED under control can help with flares. Flares can also occur after treatment. Learn about risk factors and potential triggers that can cause your TED to flare by using the Triggers and Flares Tool.

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Get treatment for TED as early as possible to help prevent further eye damage.

TED is rare and requires an expert doctor

That is why it is important to see a TED Specialist. A TED Specialist has the right experience to diagnose TED and provide you with the care you need.