Thyroid Eye Disease – What It Is and How to Deal With It

If you’ve ever heard the term thyroid eye disease and felt confused, you’re not alone. It’s a condition where the tissues around the eyes get inflamed because of thyroid problems, most often Graves’ disease. The swelling can make the eyes look bulgy, feel gritty, or even hurt. The good news? Knowing the signs early and getting the right care can keep the problem from getting worse.

Typical Signs You Should Watch For

Most people notice one or more of these clues:

  • Eyes that seem to stick out more than before.
  • Dryness, itching, or a feeling like sand is in the eye.
  • Redness or swelling of the eyelids.
  • Trouble moving the eyes sideways or up‑and‑down.
  • Double vision that comes and goes.

If any of these pop up, especially alongside a thyroid diagnosis, it’s worth chatting with a doctor right away. Catching it early gives you more treatment choices.

How Doctors Figure It Out

First, an eye doctor (ophthalmologist) will check eye movement, pressure, and the space behind the eyes. They might order an MRI or CT scan to see how much tissue is swollen. Blood tests are also useful – they show if your thyroid hormone levels are high, low, or fluctuating, which often drives the eye changes.

When the scans and labs line up with the symptoms, the diagnosis is usually clear. Some doctors use a simple scoring system (the CAS score) to rate activity and decide how aggressive the treatment should be.

Treatment Options – From Meds to Surgery

Treatment depends on how active the disease is and how much it’s affecting daily life.

  • Medication. Steroids can calm inflammation quickly, but they’re short‑term. For longer control, doctors may use a drug called teprotumumab, which specifically targets the pathways that cause the eye swelling.
  • Radiation. Low‑dose orbital radiation can shrink the tissue for people who don’t respond to meds.
  • Surgery. If the eyes stay bulgy or vision is at risk, surgeons can remove excess fat or bone around the eye (orbital decompression). Later, eyelid surgery can improve the cosmetic look and help the eyes close properly.
  • Supportive care. Artificial tears, lubricating ointments, and wearing sunglasses reduce dryness and discomfort. Elevating the head while sleeping can lessen swelling.

Most patients need a mix of these approaches. Your endocrinologist and eye specialist will coordinate care to keep thyroid hormone levels stable while treating the eye changes.

Everyday Tips to Keep Symptoms in Check

While you’re on treatment, a few lifestyle tweaks can make a big difference:

  • Stay hydrated – drinking water helps keep the eye surface moist.
  • Avoid smoking. Smoke worsens inflammation and can make surgery riskier.
  • Limit salty foods. Too much sodium can increase fluid retention, which may puff up the eye area.
  • Use a warm compress for a few minutes each day if the lids feel tight.
  • Keep follow‑up appointments. Even when symptoms improve, the disease can flare up months later.

Remember, thyroid eye disease is manageable. By recognizing the warning signs, getting a prompt diagnosis, and following a tailored treatment plan, you can protect your vision and feel more comfortable every day.

Graves’ Disease Eye Swelling (Thyroid Eye Disease): Symptoms, Causes, and Treatment Guide

Worried about puffy, irritated eyes with Graves’ disease? Learn key symptoms, causes, red flags, and proven treatments-plus a simple action plan you can follow today.

Written by

Katie Law, Sep, 1 2025