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Hyperthyroidism: Graves' Ophthalmopathy

Condition Basics

What is Graves' ophthalmopathy?

Graves' ophthalmopathy, also called thyroid eye disease, is an autoimmune disease that can occur in people with Graves' disease. In Graves' ophthalmopathy, the tissues and muscles behind the eyes become swollen. The eyeballs may stick out farther than normal. This can occur before, after, or along with other signs of hyperthyroidism.

What are the symptoms?

Most people who develop Graves' ophthalmopathy have one or more of the following symptoms:

  • Dry, itchy, irritated eyes
  • A staring or bug-eyed look
  • Sensitivity to light; watery, teary eyes; and a feeling of pain or pressure around the eyes
  • Difficulty closing the eyes completely
  • Double vision, especially when looking to the sides
  • Pain when moving the eyes up and down and from side to side

What happens when you have Graves' ophthalmopathy?

Graves' ophthalmopathy may get worse if your thyroid levels are out of balance. It may also get worse temporarily if you are given radioactive iodine therapy. Smoking increases your chances of developing Graves' ophthalmopathy. And it can make the condition worse.

How is it treated?

Treatment will depend on how severe your symptoms are. Treatments may include corticosteroid medicines, immunosuppressants, radiation therapy, thyroid surgery, or eye surgery. You and your doctor will also work to get your thyroid level into a normal range. If you are a smoker, your doctor will advise you to stop. Smoking will make your symptoms worse.

To help reduce dryness and discomfort, you can use saline eye drops (artificial tears) during the day. And at night use an eye ointment or gel. Wearing glasses or sunglasses will help protect your eyes from light, cold, and wind. Raising the head of your bed at night will also help reduce your symptoms.

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Current as of: October 12, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
David C.W. Lau MD, PhD, FRCPC - Endocrinology