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Updated on June 15, 2026
Thyroid eye disease (TED) is an autoimmune condition where the immune system damages the soft, structural tissues that support the eyes. This tissue damage causes the eyes to bulge forward, affecting both function and appearance.
Eyes may become itchy, red, irritated, painful with movement, dry, watery, and/or sensitive to light. Double vision can also occur if the eyes shift out of alignment. Vision loss also occurs in some cases.
The bulging appearance of the eyes changes a fundamental aspect of a person’s appearance and is understandably a significant source of psychological and emotional distress. Mental health should be a focus of treatment.
Most cases of TED occur secondarily to Graves’ disease, an autoimmune disorder that affects the thyroid. The thyroid is a hormone-producing gland located in the front of the neck. Less commonly, TED occurs on its own or is associated with other thyroid conditions.
TED requires a multidisciplinary approach to treatment
People diagnosed with TED are managing multiple conditions that affect multiple areas of their health. Beyond the eye-related symptoms that occur with TED, Graves’ disease and other thyroid disorders can affect many areas of a person’s health, and these can lead to a wide range of symptoms.
Common symptoms of Graves’ disease:
- Enlarged thyroid (called a goiter)
- Anxiety, irritability, other mood changes
- Fast and/or irregular heartbeat
- Intolerance/sensitivity to heat, increased sweating
- Tremors (often affecting the hands)
- Unexplained weight loss
- Changes in menstrual cycles
- Erectile dysfunction
- Frequent bowel movements, diarrhea
- Skin thickening (called Graves’ dermopathy)
- Hair thinning
- Fatigue, muscle weakness
- Sleep disturbances
Additionally, people with TED and Graves’ disease are at an increased risk of other health conditions, including other autoimmune disorders, diabetes, cardiovascular disease, osteoporosis, gastrointestinal disorders, and kidney disease.
A treatment plan will need to account for multiple conditions and multiple symptoms. People with TED will work with a multidisciplinary team of providers with different specialities.
Common members of a multidisciplinary team include:
- Ophthalmologist
- Endocrinologist
- Surgeons
- Primary care provider
- Registered dietitian
- Mental health professional
- Clinical social worker
- Additional specialists, such as a cardiologist or gastroenterologist
- Radiologists and other imaging specialists
- Pharmacists
- Specialty nurses
A treatment plan for TED
TED is a different experience for every person, and there is no one-size-fits-all approach to treatment. A treatment plan will need to account for TED, Graves’ disease (or other associated thyroid disorder), and any coexisting conditions.
A treatment plan will depend on symptoms, severity of symptoms, and considerations about a person’s overall health.
A major consideration in the treatment of TED is the current phase of the disease. TED occurs in two main phases:
- During the active inflammatory phase, there is ongoing inflammation in the tissues around the eyes. Here, treatment may include medications and other therapies to reduce inflammation, biologic therapy, steps to protect the eyes and ease symptoms, and lifestyle changes (such as reducing sodium intake and quitting smoking, if you smoke).
- During the inactive stable phase, the inflammation has subsided but there is lasting damage to the supportive tissues around the eyes. Therapies to ease symptoms remain important. Treatment may involve surgery to improve the appearance and function of the eyes.
Before starting any treatment or procedure, it’s important to talk to your healthcare provider about potential side effects, drug interactions, and health risks.
For information about diagnosis, health concerns, and treatment, your healthcare providers will always be your best source of information.
