What Is It?

Graves’ eye disease, also called Graves’ ophthalmopathy, is a problem that develops in people with an overactive thyroid caused by Graves’ disease. Up to one-half of people with Graves’ disease develop eye symptoms. Usually the eye symptoms are mild and easily treated.

Eye problems result from the swelling of tissues, muscles and fat in the socket behind the eye. This swelling causes the proptosis, or pop-eyed look, that is commonly associated with Graves’ disease. In serious cases, the swelling can cause the muscles that move the eyeball to become so stiff that the eye cannot move properly, or the swelling can put pressure on the optic nerve, impairing vision. The eyelids and membranes may retract as they swell, which can lead to exposure and infection of the cornea, the transparent, dome-shaped “window” that lies directly over the eye’s pupil and iris.

Symptoms of Graves’ eye disease include:

• Early symptoms — Feeling of irritation in the eyes, double vision, excessive tearing or dry eye, forward displacement of the eye, and sensitivity to light



• Late symptoms — Swelling of the eye, inability to move the eye, corneal ulceration, and, rarely, loss of vision

If you already have been diagnosed with Graves’ disease, a doctor may diagnose eye disease by examining your eyes and finding swelling and enlargement of the eye muscles. A Computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of the eye muscles may be helpful. Graves’ disease usually is associated with other symptoms of overactive thyroid, but the classic symptoms of hyperthyroidism are not always present.

Graves’ eye disease usually improves on its own, but in some cases, it must be treated.

Graves’ disease cannot be prevented, and usually, the associated eye disease cannot be prevented. However, some studies suggest that patients with hyperthyroidism from Graves’ disease who are given corticosteroids, such as prednisone (sold under several brand names), by mouth at the same time they receive therapy for the thyroid have less risk of developing Graves’ eye disease.

In mild cases, cool compresses, sunglasses and artificial tears provide relief. People with Graves’ eye disease often are advised to sleep with their heads elevated to reduce eyelid swelling. If double vision is a continuing problem, glasses containing prisms may be prescribed or surgery on the muscles may be advised.

Corticosteroids, taken by mouth, may help temporarily with early stages of eye-muscle problems, but they are not effective later in the disease. Corticosteroids, taken by mouth or given intravenously (into a vein), may be used to treat compression of the optic nerve, which is the most serious complication of Graves’ eye disease.

In more stubborn cases, radiation treatment of the eye socket can ease swelling. However, radiation near the eye may damage the retina.

When sight is threatened, a type of surgery called orbital decompression is done. In this procedure, a bone between the eye socket (orbit) and sinuses is removed to allow more space for the swollen tissues. Other operations that can be done for serious Graves’ eye disease are muscle surgery to realign the eyes and eyelid surgery to reposition the eyelid.

Call your doctor if you notice any changes in the appearance of your eye or if you develop any of the symptoms of Graves’ eye disease.

Most of the symptoms of Graves’ disease, including eye symptoms, can be treated successfully.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.