Graves' Ophthalmopathy (Thyroid Eye Disease, TED)

Thyroid eye disease affects the tissues and muscles in the eye socket behind and around the eyes. Antibodies against the thyroid-stimulating hormone receptor, along with antibodies against the insulin-like growth factor-1 receptor, are thought to trigger an inflammatory cascade that activates orbital fibroblasts and leads to swelling and expansion of the orbital tissue. It most often accompanies Graves' disease and its related hyperthyroidism, though a small share of people with thyroid eye disease have normal or even low thyroid function.

A 2025 review described the age-adjusted annual incidence of clinically significant disease as an estimated 16 per 100,000 women and 2.9 per 100,000 men, and noted that most cases are mild, with about 1 in 5 moderate to severe. Risk factors include smoking and the level of thyrotropin receptor antibodies, and cases that threaten vision need prompt specialist care.

Common signs

Bulging or staring eyes, eyelid retraction, redness and swelling, dryness or excessive tearing, light sensitivity, a feeling of grit, double vision, and eye discomfort.

This is a plain-language summary for orientation, not a diagnosis. Mechanisms are described as current understanding, not settled fact. Work with your own clinician for your care.