Thyroid Eye Disease
Thyroid Eye Disease (also called Graves' ophthalmopathy) is an autoimmune condition that affects the muscles and fat behind the eye — causing bulging, double vision, and in severe cases, vision loss. Expert evaluation is essential for protecting your sight.
Understanding Thyroid Eye Disease
TED is an autoimmune disorder most commonly associated with Graves' disease (hyperthyroidism). The immune system attacks the tissues behind and around the eye — causing inflammation, swelling, and expansion of the eye muscles and fat that push the eyeball forward.
TED has two phases: an active phase (6–24 months of inflammation and worsening) and an inactive phase (stabilization). Treatment goals differ by phase — controlling inflammation during the active phase, and correcting residual changes during the inactive phase.
TED can occur even when thyroid hormone levels are controlled — making ophthalmologic monitoring essential for all Graves' disease patients.
Signs & Symptoms
Managing Thyroid Eye Disease
Medical Management
Artificial tear drops, topical medications, oral or IV steroids, and other anti-inflammatory therapies reduce inflammation and protect the eye surface during the active phase.
Radiation Therapy
Orbital radiation (external beam) can reduce inflammation in select patients with active TED who have not responded adequately to steroids.
Orbital Decompression
Surgery to remove bone or fat from the orbit can reduce proptosis (eye bulging) and relieve pressure on the optic nerve. Typically performed after TED has stabilized.
Eyelid & Strabismus Surgery
After decompression, patients may need strabismus surgery to correct double vision, and/or eyelid procedures to correct lid retraction and improve appearance.
Expert TED Care at Hill Country Eye Center
Dr. Shepler has extensive experience managing thyroid eye disease at all stages. Early evaluation is critical — especially when your vision is at risk.