Thyroid Eye Disease Symptoms: What to Watch For

Do your eyes still feel irritated after using eye drops? Maybe your eyes bulge even when you feel relaxed. Or you’ve noticed more light sensitivity while driving home from work. These changes are easy to brush off, but they may be linked to thyroid eye disease. 

Understanding thyroid eye disease symptoms can help you know when it’s time to seek care. At True Eye Care, we help patients identify concerns that could point to larger health conditions, including thyroid-related eye problems. 

What Is Thyroid Eye Disease?

Thyroid eye disease (TED) is an autoimmune condition that causes inflammation in the tissues, muscles, and fat surrounding the eyes. It most commonly occurs in people with Graves’ disease, an autoimmune disorder that affects the thyroid gland, although it can also develop in people with other thyroid conditions.

According to the American Thyroid Association, about one in every three people with Graves’ disease develops eye symptoms. Symptoms can range from mild irritation to significant vision changes.

Thyroid eye disease typically develops in two phases: an active phase and an inactive phase.

During the active phase, inflammation causes the tissues around the eyes to swell and enlarge. This is when thyroid eye disease symptoms often become more noticeable and worsen as time goes on. You may experience dry eyes, eye bulging, eyelid retraction, double vision, light sensitivity, or discomfort around the eyes. In rare cases, swelling can place pressure on the optic nerve, threatening your vision.

The active phase typically lasts between one and three years before transitioning to the inactive phase. At that point, inflammation stabilizes and the disease stops progressing. Some changes caused by tissue damage or scarring may remain, including bulging eyes and double vision. Depending on the severity of those changes, some patients may benefit from medical treatment or surgery to improve comfort, function, or appearance. 

Common Thyroid Eye Disease Symptoms

Because Colorado’s dry climate can already contribute to irritation and dryness, some people initially mistake thyroid eye disease symptoms for dry eye, allergies, or eye strain. 

Thyroid eye disease symptoms include:

• Dry, gritty, or irritated eyes
• Excessive tearing
• Redness
• Light sensitivity
• Swelling around the eyelids
• Eye pain or pressure
• Bulging or protruding eyes (proptosis)
• Double vision
• Difficulty moving your eyes comfortably

Who Is Most at Risk for Thyroid Eye Disease?

While thyroid eye disease can affect anyone, certain factors increase the likelihood of developing the condition. You may be more at risk if:

• You’re a woman. The Cleveland Clinic notes that women are five times more likely to get Graves’ disease and thyroid eye disease compared to men.
  
• You have a thyroid condition. Thyroid eye disease is most commonly associated with Graves’ disease, though it can occur with other thyroid disorders as well.
  
• You smoke. People who smoke are more likely to develop thyroid eye disease and may experience more severe symptoms than non-smokers. For people already diagnosed with TED, quitting smoking can help reduce the risk of disease progression. 

When Should You Schedule an Eye Exam?

You should schedule an eye exam if your symptoms persist, worsen, or affect your daily activities. 

Pay particular attention if you experience:

• New double vision
• Eye bulging
• Difficulty closing your eyes completely
• Persistent pain or pressure
• Changes in color vision
• Blurry vision that doesn’t improve

Even if symptoms seem mild, an eye exam with your primary eye doctor can help determine whether you’re dealing with dry eye, allergies, thyroid eye disease, or another condition entirely. Many eye conditions share similar symptoms, which makes professional evaluation valuable.

How Thyroid Eye Disease Is Diagnosed

Diagnosis typically involves a combination of an eye exam, medical history, and, in some cases, imaging studies.

During an exam, your primary eye doctor may evaluate your eye movement, eyelid position, eye bulging, double vision, and signs of inflammation on the surface of the eye. They may also ask about thyroid conditions such as Graves’ disease and any recent changes in your symptoms.

If thyroid eye disease is suspected, additional testing may be recommended. Blood work can help assess thyroid function, while imaging studies such as a CT scan or MRI can show changes in the muscles and tissues surrounding the eyes. Some patients may also be referred to an endocrinologist to help manage the underlying thyroid condition.

Early diagnosis can help protect vision and identify treatment options before symptoms become more severe. 

How Is Thyroid Eye Disease Treated?

As thyroid eye disease transitions from the active phase to the inactive phase, inflammation stabilizes and some symptoms may improve, like redness, irritation, and discomfort.

However, some changes can persist after inflammation resolves. Changes in eye appearance or alignment may remain if the disease has caused lasting changes to the tissues surrounding your eyes.

Treatment depends on the severity of the condition and the symptoms involved. For milder cases, lubricating eye drops may help relieve irritation and dryness. Patients experiencing double vision may benefit from prism glasses that improve visual comfort. 

More advanced cases may require medications that reduce inflammation, including newer therapies such as Tepezza®, which was developed specifically for thyroid eye disease. Surgery may also be considered when lasting changes affect your vision, comfort, or appearance.

Because thyroid eye disease symptoms can change as time goes on, regular eye exams are vital for monitoring the condition and determining your treatment options.

Protecting Your Long-Term Eye Health

Thyroid eye disease symptoms can start gradually, making them easy to miss. What feels like occasional dryness or irritation today could be an early sign of an underlying condition that deserves attention.

If you’ve noticed ongoing discomfort, changes in your vision, or concerns about thyroid eye disease symptoms, a comprehensive exam at True Eye Care will provide answers and give you the best opportunity to protect your vision for the future.