Thyroid eye disease (Graves' eye disease)

What it is

Thyroid eye disease, also called Graves' orbitopathy, is an autoimmune condition where the immune system inflames the muscles and fat behind the eyes. It is most often associated with an overactive thyroid but can occur with normal or underactive thyroid function too.

Common symptoms

Symptoms can affect appearance, comfort and vision.

• Bulging or staring-looking eyes (proptosis)
• Dry, gritty, red or watery eyes
• Swollen, puffy eyelids and a retracted upper lid
• Double vision, and rarely reduced vision in severe cases

Causes and risk factors

It is an autoimmune process most often linked to Graves' disease. The single most important risk factor that can be changed is smoking, which makes the disease more likely and more severe. It is also more common in women.

Treatment

Management is shared between thyroid specialists and eye specialists. Stopping smoking is vital, as is getting thyroid levels under control. Lubricating drops ease dryness, while active inflammation may need anti-inflammatory treatment, and surgery can later correct bulging, lid position or double vision. Sudden loss of vision or colour vision needs urgent care.