Thyroid Related Eye Disease

Thyroid Eye Disease (TED) Graves' Ophthalmopathy disease may possibly present clinically with one of the following characteristic signs:

Graves Disease

Thyroid Eye disease

Eye Problems In Thyroid Eye Disease

Photo of a patient with Graves' disease

Corneal disease

Lid Retraction

Increased pressure around the eyes


Strabismus and Double vision

Optic neuropathy

Other symptoms

Some other symptoms that patients with thyroid eye disease may experience include lid tremor (when eyes are closed), infrequent blinking, difficulty eversing the eyelid and decreased forehead wrinkling.

Thyroid Eye Disease in detail

More frequent signs:

Less frequent signs:
  • lid lag (upper and lower)
  • exophthalmos
  • diplopia
  • lid edema
  • chemosis
  • conj injection over recti
  • increased IOP with elevation
  • keratopathy
  • closed lid tremor
  • infrequent blinking
  • difficult eversion upper lid
  • bruit over eye
  • decrease forehead wrinkling with upgaze
  • increased hippus
  • pigmented lids

Werner's Classification

NO SPECS, with each class in four grades 0-4, a, b, c: mild to severe

Symptom Type I Type II
Sex predilection Female  
Proptosis Symmetric Unilateral or bilateral
Eyelid retraction Symmetric Unilateral or bilateral
Orbital inflammation Minimal  
Extraocular muscle inflammation/ restriction Minimal Frequent
Chemosis Unusual Usual
diplopia Unusual Frequent
Compressive optic neuropathy Unusual Frequent


Systemic thyroid may possibly be hyperthyroid, hypothyroid, or euthyroid. Treatment may possibly include topical lubrication, systemic steroids, orbital decompression surgery, extraocular muscle adjustment, eyelid recession surgery and radiation therapy.

Radiological Findings

Hypothyroidism Hypothyroidism
Hypothyroidism Hypothyroidism


Diagnosis of Thyroid Eye Disease

Treatment of Thyroid Eye Disease

There are some simple measures that can be taken to help treat thyroid eye disease.

Medical treatment

Surgical treatment