Please ensure JavaScript is enabled for purposes of website accessibility Thyroid Eye Disease vs. Graves Disease | What's the Difference?

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Thyroid Eye Disease vs Graves’ Disease

TED and Graves’ disease are different conditions that require different treatments

If you have Graves’ disease or another thyroid disorder, you may have heard of the eye condition known as Thyroid Eye Disease (TED), which is sometimes referred to as Graves’ Eye Disease.

TED and Graves’ disease are both autoimmune disorders. That means your body’s immune system attacks your own tissue by mistake. In Graves’ disease, your thyroid is affected. When you have Thyroid Eye Disease, it affects the muscle and fat behind your eyes. Watch the video below to learn more about the differences between TED and Graves’ disease, and the risk factors for developing TED.

  • 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

Many patients who have Graves' disease develop TED. But they are separate conditions that require different treatment. There’s a lot of information about these two conditions, but some of it can be confusing. Scroll on to find out what’s myth and what’s fact.

  • MYTH: Thyroid Eye Disease (TED) is a symptom of Graves’ disease.

    FACT: TED is a different condition from Graves’ disease.

    Many people think Graves’ disease and Thyroid Eye Disease (TED) are the same. That’s because people often have both diseases at the same time.

    That is also because both are autoimmune diseases. This means your body’s immune system attacks a healthy part of your body by mistake.

    If you have Graves’ disease, your body’s immune system attacks the thyroid. If you have TED, your body’s immune system attacks the tissue behind your eyes. This can cause a number of different changes to your eyes.

    TED is often called by different names containing the word Graves’ or thyroid, including:

    • Graves’ eye disease
    • Graves’ ophthalmopathy (GO)
    • Graves’ orbitopathy
    • Graves’ disease eyes
    • Thyroid-associated ophthalmopathy (TAO)
    • Thyroid orbitopathy

    Get to know the symptoms of TED so you know what to watch for.

    Learn more

  • MYTH: You only get Thyroid Eye Disease (TED) after you develop Graves’ disease.

    FACT: You can develop TED without having Graves’ disease.

    While it’s true that many people are diagnosed with Graves’ before being diagnosed with Thyroid Eye Disease (TED), it’s not always the case. In fact, about 1 in 10 people with TED develop it without having Graves’ disease.

    It’s also not uncommon for people to be diagnosed with TED before, during, or even after getting diagnosed with Graves’ disease.

    People diagnosed with TED may also be diagnosed with a different type of thyroid condition called Hashimoto’s disease or Hashimoto’s hypothyroidism (hash-i-moh-tohz) (high-poe-thigh-roid-izm).

  • MYTH: Thyroid Eye Disease (TED) affects the same parts of the body as Graves’
    disease and Hashimoto’s disease.

    FACT: TED affects the eyes. Graves’ disease and Hashimoto’s disease affect the thyroid.

    Although “thyroid” is in the name, Thyroid Eye Disease (TED) is an autoimmune condition that affects the muscle and fat tissue behind your eyes, not your thyroid. It causes this tissue to swell, which can make your eyes bulge and cause other symptoms.

    Learn the common symptoms of TED

    Unlike TED, Graves’ disease affects the thyroid, causing its own set of changes, such as a fast or irregular heartbeat or anxiety.

    Learn more about Graves’ disease symptoms

    Hashimoto’s disease also affects the thyroid and has its own set of common symptoms.

  • MYTH: Medicine for Graves’ disease will work for Thyroid Eye Disease (TED).

    FACT: TED and Graves’ disease need different treatments.

    Medicine for Graves’ disease won’t work for Thyroid Eye Disease (TED), and medicine for TED won’t work for Graves’ disease. That’s because TED and Graves’ disease are different conditions and need different treatments.

    Graves’ disease affects the thyroid, while TED affects the eyes. So, for Graves’ disease, you should see a doctor who specializes in the thyroid: an endocrinologist. For Thyroid Eye Disease, you should contact a Thyroid Eye Disease Specialist, who is usually an ophthalmologist with advanced training and experience treating TED.

    Graves’ disease treatment:

    TED treatment:

    • Doctors may use other types of medicines to treat your eye symptoms and/or surgery to help fix your eyes

    Learn more about treatment options

    If you have TED, there’s a treatment option available that doesn’t require steroids or surgery.

  • MYTH: Any doctor can treat Thyroid Eye Disease (TED).

    FACT: If you have TED, you should see a doctor who has experience treating TED.

    Thyroid Eye Disease (TED) is a unique and rare eye condition, and not all doctors are used to treating it. That’s why it’s important that you see a doctor who has the right experience—a TED Specialist.

    TED Eye Specialists are ophthalmologists who usually have advanced training, such as oculoplastic surgeons, and neuro- ophthalmologists.

    While there are about 20,000 eye doctors in the US, most are not used to seeing TED patients. TED Specialists have advanced training in specific types of eye and vision care.

    Learn more about TED Eye Specialists

    TED is rare and requires an expert doctor.
    Make sure you contact a TED Eye Specialist to get the right kind of care.

    Find a TED Eye Specialist

  • MYTH: Thyroid Eye Disease (TED) doesn’t need to be treated right away.

    FACT: The sooner TED is treated, the better. TED may cause serious eye damage.

    Thyroid Eye Disease (TED) is a lifelong condition. If left untreated, TED can get worse over time.

    Spot TED symptoms, avoid serious damage

    Keeping track of your symptoms––and talking with your doctor right away about any changes––can have a big impact. Speak up for the care you deserve.

    Observe and track your TED symptoms

If you have Graves' disease and eye symptoms, it could be TED

Use the TED Screener for Graves’ Disease Patients Tool below to see if the eye symptoms you are experiencing could be TED. You can then share the results with your doctor.

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