TED presents with a range of symptoms, from mild discomfort to more severe eye changes that may impact vision. Below are the most common signs to look out for:

1. Bulging Eyes (Proptosis)

One of the most distinctive signs of TED is proptosis, where the eyes appear to bulge forward due to swelling and inflammation in the tissues behind the eye. This symptom often develops gradually, making it difficult to notice in its early stages.

2. Eye Dryness, Redness, and Irritation

Patients with TED frequently experience chronic dryness, redness, and a gritty sensation in the eyes. While these symptoms mimic dry eye disease, they often persist despite using over-the-counter lubricating eye drops.

3. Eyelid Swelling or Retraction

Swollen or retracted eyelids can give the eyes a staring appearance, which may be confused with allergic reactions or conjunctivitis. This symptom results from inflammation affecting the muscles and tissues surrounding the eye.

4. Double Vision (Diplopia)

Swelling of the eye muscles can lead to misalignment of the eyes, causing double vision (diplopia). This symptom may start as mild but can worsen over time, especially when looking in different directions.

5. Eye Pressure or Pain

Many TED patients experience a persistent feeling of pressure or pain around the eyes, which may worsen with movement or eye strain. This discomfort results from increased tissue swelling within the eye socket.

6. Sensitivity to Light (Photophobia)

Inflammation in TED can make the eyes highly sensitive to light, often leading to discomfort in bright environments. Many people initially mistake this symptom for migraines or general eye fatigue.

7. Restricted Eye Movement

As TED progresses, the swelling and thickening of eye muscles can limit the movement of the eyes. Patients may struggle to move their eyes in certain directions, leading to discomfort or difficulty with peripheral vision.

Since TED symptoms can vary in severity and progress differently in each individual, it is essential to consult an eye specialist if any of these signs persist or worsen.

How Common Is Thyroid Eye Disease?

While TED may seem rare, it is relatively common in individuals with thyroid disorders, particularly Graves’ disease. Research indicates that up to 50% of people with Graves’ disease will develop some form of TED.

According to the National Library of Medicine, the estimated annual incidence of TED in the U.S. is:

• 16 per 100,000 females
• 2.9 per 100,000 males

The condition tends to occur in two peak age groups:

• Women: Most commonly affected between 40–44 yearsand 60–64 years
• Men: More frequently diagnosed between 45–49 yearsand 65–69 years

Older adults diagnosed with TED may experience more severe symptoms, including restrictive myopathy (limited eye movement) and dysthyroid optic neuropathy (DON), which can threaten vision.

Risk Factors for Developing Thyroid Eye Disease

Several factors can increase the likelihood of developing TED or worsening its symptoms, including:

✅ Thyroid Disorders: The strongest risk factor is having an underlying thyroid condition, particularly Graves' disease, but TED can also occur in individuals with hypothyroidism or normal thyroid function.

✅ Smoking: Research has shown that smoking significantly increases the risk of developing TED and can worsen the severity of symptoms. Smoking cessation may help reduce disease progression.

✅ Genetics: A family history of autoimmune thyroid disorders may increase susceptibility to TED.

✅ Gender: Women are more likely to develop TED, although men may experience more severe cases when diagnosed.

✅ Stress and Environmental Triggers: Chronic stress and exposure to environmental pollutants have been linked to immune system dysfunction, potentially contributing to the onset or worsening of TED.

Treatment Options for Thyroid Eye Disease

TED treatment depends on the severity of symptoms. Options range from conservative management for mild cases to targeted therapies for more advanced stages.

1. Medications

• Tepezza (Teprotumumab):This FDA-approved medication specifically targets the inflammatory process driving TED, helping to reduce eye bulging, double vision, and swelling. Clinical studies have shown significant improvements in both appearance and vision after treatment (Source: Tepezza).
• Corticosteroids:Anti-inflammatory drugs may be prescribed to manage swelling and discomfort in moderate cases.

2. Supportive Care for Mild Cases

• Artificial Tears:Lubricating eye drops help alleviate dryness and irritation.
• Sunglasses:Protecting the eyes from light sensitivity can provide relief.
• Prism Glasses:These may help correct double vision for patients experiencing diplopia.

3. Surgical Interventions for Severe Cases

• Orbital Decompression Surgery:Performed in severe cases, this procedure relieves pressure in the eye socket, reducing proptosis and preventing damage to the optic nerve.
• Strabismus Surgery:Helps correct eye misalignment and improve double vision.
• Eyelid Surgery:Can improve eyelid position and restore a more natural appearance.

The Importance of Early Detection

Recognizing the early symptoms of Thyroid Eye Disease is essential for timely intervention and preventing severe complications. Awareness of TED’s prevalence, risk factors, and treatment options empowers individuals to seek specialized care as soon as symptoms appear.

If you or someone you know has persistent eye discomfort, swelling, or other TED-related symptoms—especially with a history of thyroid conditions—consult an eye care professional promptly. Early treatment can help manage symptoms effectively and protect long-term eye health.