Telehealthcare provider explaining what causes thyroid eye disease

What Causes Thyroid Eye Disease?

Medically reviewed on July 14, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Nearly one in one hundred Americans have Graves’ disease, and more than 33% of Graves’ patients experience Graves’ ophthalmopathy—also known as "thyroid eye disease." [1,2]

What causes thyroid eye disease, and who is at the highest risk of developing this disease?

In this guide, an overview of thyroid eye disease is provided to help you learn more about this relatively common condition.

What Is Thyroid Eye Disease?

Thyroid eye disease is a condition relating to thyroid function. The thyroid gland plays a vital role in the body, but production of excess thyroid hormone levels can lead to a cascade of effects, including thyroid eye disease.

The eye socket, including the eye muscle, optic nerve, and eyelids, can experience inflammation when the thyroid gland isn't functioning properly, leading to this thyroid/eye condition.

You might hear thyroid eye disease (TED) called by two other names in medical literature, which include [3]:

  • Graves’ eye disease (GED)
  • Graves’ ophthalmopathy (GO)

However, all three of these names describe a phenomenon in people with TED/Graves’ disease, an autoimmune disorder that can cause an overactive thyroid (hyperthyroidism). [3]

Graves’ Disease

The thyroid gland produces hormones that help your body regulate a variety of functions, from metabolism to digestion. [4] If you have Graves’ disease, your immune system can attack the thyroid. This can lead to [1]:

  • Excessive hormone production – While under attack, your thyroid produces additional hormones to ensure your body can continue functioning.
  • Body process acceleration – If your body is working with more thyroid hormones than it really needs, some of its functions can speed up. For instance, since thyroid hormones are critical to digestive functions, you might experience weight loss even if you’re eating enough food to sustain or increase body weight. [2]
  • Hyperthyroidism symptoms – An overactive thyroid gland can also create other issues in your body when left unmanaged. These include irregular heartbeat, anxiety, shaky hands, excessive sweating, and bowel distress. [1] In addition, your thyroid may become enlarged—a condition called ‘goiter’. [1] If you're curious about how to diagnose hyperthyroidism, it can usually be done through an at-home blood test or by seeing a healthcare provider.

Graves’ Eye Disease

Another potential complication of Graves’ disease is thyroid eye disease—more than 33%of Graves’ patients develop symptoms of this disease. [1]

The most common symptom of thyroid eye disease is proptosis, or bulging and swollen eyes.3 Besides the proptosis, people with the disease may also experience eye problems such as [3]:

  • Eyelid symptoms – Your eyelids may swell, which can prevent them from closing all the way or can make them pull back more than usual when your eyes are open.
  • Vision issues – While thyroid eye disease doesn’t typically cause blindness, some severe cases can create double vision, sensitivity to light, or other vision difficulties.
  • Pain and discomfort – People with thyroid eye disease often feel like they have sand or dirt in their eyes. They may also experience eye pain or have trouble moving their eyes when they look around.

Other symptoms may include dry or watery eyes as well as redness around the eyes. While symptoms typically appear in both eyes, thyroid eye disease may only be present in one eye in some cases. [3]

Who Is Most Likely to Get Thyroid Eye Disease?

Researchers are still working to determine the cause of Graves’ disease and the underlying cause of thyroid eye disease.2 Healthcare experts currently hypothesize that Graves’ disease results from genetic factors and environmental triggers.

Statistically speaking, you might be more likely to develop Graves’ disease (and, as a result, thyroid eye disease) if you have [1]:

  • A family history of Graves’ or Hashimoto’s disease
  • Other autoimmune disorders like:
    • Vitiligo (a skin disorder)
    • Autoimmune gastritis (a stomach lining issue)
    • Type 1 diabetes (difficulty regulating blood sugar and insulin)
    • Rheumatoid arthritis (joint inflammation)
  • A history of nicotine use

Graves’ disease is also much more common in women than in men, and it typically develops before the age of 40. [3]

Does Thyroid Eye Disease Go Away?

In many cases, thyroid eye disease resolves on its own.3 However, symptoms of this thyroid disorder usually last for up to two years, so people will typically seek out treatment to:

  • Ease their eye pain or discomfort from symptoms
  • Treat vision problems that impact their quality of life

The most common treatments for Graves’ eye disease include:

  • Over-the-counter eye drops to treat eye irritation and relieve the “gritty” feeling
  • Prescriptions like prednisone (a steroid) and rituximab (a monoclonal antibody drug)
  • Smoking cessation
  • Eyeglasses (sometimes tinted)
  • Orbital decompression surgery, which increases the size of your eye socket Radiation therapies

How Do You Prevent Thyroid Eye Disease?

Since an autoimmune disorder can cause thyroid eye disease, prevention is difficult—you may not know that you have a genetic predisposition to Graves’ disease and other thyroid issues until you start to show symptoms.

However, one of the best ways to prevent any health challenge is to stay on top of preventative care. This can look like:

  • Routine testing – Your healthcare provider may order annual (or more frequent) lab tests to monitor your thyroid hormone production levels. Keeping up with this routine blood work can help you and your healthcare provider identify potential issues before you present symptoms.
  • Vision check-ups – Whether or not you need glasses, you should keep up with your eye health and vision exams. Ask your healthcare provider for an eye exam at your yearly visit—or ask for a referral to an eye specialist if you think you’re predisposed toward thyroid eye disease.

Get the Thyroid Care You Need with Everlywell

While healthcare experts are still studying what causes thyroid eye disease, and its precursor Graves’ disease, you might be at a higher risk if you have a history of autoimmune disorders, or if someone in your immediate family has this condition. [3]

When it comes to prevention, keeping up with routine medical care is key—and Everlywell is here to help with easy-to-access telehealth services. From the comfort of your home, our licensed clinicians can connect you with at-home lab tests, like our Thyroid Test, as well as prescription medications to help you manage your condition.

Learn more about online thyroid care from Everlywell.

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Thyroid and Period Changes: What's the Connection?


  1. National Institute of Diabetes and Digestive and Kidney Diseases. Graves’ Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Published March 17, 2019. URL. Accessed June 12, 2023.
  2. Graves disease: MedlinePlus Genetics. URL. Accessed June 12, 2023.
  3. Graves’ Eye Disease | National Eye Institute. URL. Accessed June 12, 2023.
  4. Thyroid Diseases. Published 2019. URL. Accessed June 12, 2023.
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