Thyroid eye disease (TED) is a chronic autoimmune disease characterized by its symptoms of inflammation of the eye muscles and fatty tissue, resulting in eyes pushed forwards that appear ‘bulging.’ TED often occurs as a result of an overactive thyroid gland due to Graves’ disease and often occurs after the diagnosis of thyroid disorder. Symptoms can be managed with treatments and medications such as Tepezza. Here are some early signs of thyroid eye disease to be on the lookout for:

1. Eye bags
Due to the inflammation of the eye muscles and fatty tissue, it is normal to get eye bags with TED. Eye bags should reduce with treatment of TED, but if they are still significant, some patients consider aesthetic treatments such as skin care, wrinkle relaxers, and fillers that are injected.

2. Dry or gritty eyes
With TED, the muscles around the eyes become affected. The upper lid may pull up whilst the lower lid pulls down—this paired with the build up of tissue behind the eye and ‘bulging’ makes it challenging to close your eyes tight. If you don’t blink enough or cannot close your eyes tightly, moisture will quickly evaporate and result in dry eyes. TED may also result in a reduced production of tears, another cause of dry eyes.

3. Swelling and pain in or behind the eyes
As mentioned, TED causes the inflammation of eye muscles and fatty tissue. This can result in swelling around the eyes that pushes the eye forward, thus causing pain. Not only does the pain come from the swelling and push of the eye, being unable to blink or close your eyes fully can dry them out and result in even further pain in the area.

4. Low tolerance of bright lights
Due to eye pain, patients with TED may have a hard time closing their eyes and their upper eyelid may retract, resulting in exposure of the cornea. With this exposure, patients may experience light sensitivity.

5. Blurred vision
As a result of swelling in the muscles around the eye, your eyes may no longer move in line with each other, causing blurry or double vision. Furthermore, some medications to help treat TED have side effects that include blurred or doubled vision. It’s important to be aware of potential side effects with medications and talk to your doctor if you’re experiencing any issues.

6. Difficulty moving the eyes
With the swelling, pain, and inflammation, moving the eyes up and down, side to side, may become more challenging. Whether it’s too painful or the eyes become too stiff due to the swelling, this symptom can be very frustrating to deal with.

7. Change in appearance of the eye
As noted, with TED, the inflammation of eye muscles and tissue can push the eyes forward, resulting in a changed appearance of the eye. Often described as ‘bulging’ or ‘staring’, this is one of the most common signs of TED. The eye and eyelids also may become red.