Thyroid eye disease is a chronic autoimmune disorder causing inflammation in the muscles and other tissues behind the eye. It can lead to other eye complications, including glaucoma.
Thyroid eye disease is sometimes referred to as Graves’ eye disease, given the close link between the two conditions —
However, thyroid eye disease can occur in people with other thyroid disorders, and some people with typical thyroid function can also develop thyroid eye disease.
Inflammation and swelling of the tissues in the eye socket (known as the orbit) can lead to various symptoms with thyroid eye disease,
- dry, gritty, or irritated eyes
- red or watery eyes
- puffy eyelids
- bulging of the eyes, which may make it hard to close the eyelids
- sensitivity to light
- double vision
As the disease worsens, it may lead to more serious complications, such as corneal ulcers or loss of vision.
Thyroid eye disease can also lead to other eye complications, including glaucoma. This article explores the link between thyroid eye disease and glaucoma, as well as steps that you can take to help prevent or manage serious complications with thyroid eye disease.
Glaucoma is a group of eye conditions caused by damage to the optic nerve, which
Changes in pressure within the eye caused by thyroid eye disease can affect many aspects of eye health, including optic nerve function. This means that thyroid eye disease increases the likelihood of developing glaucoma.
A 2024 analysis of people enrolled in the National Institutes of Health (NIH) All of Us Research Program examined the frequency of glaucoma among those with thyroid eye disease. In this study, 29% of people with thyroid eye disease had glaucoma compared with 6% of people without thyroid eye disease.
Even after adjusting for possible confounding factors, the researchers determined that people with thyroid eye disease were 3.3 times more likely to develop glaucoma than those without.
Another 2024 study also found that in people with glaucoma, those who also have thyroid eye disease typically have worse nerve damage and faster progression of disease than those without thyroid eye disease.
The causes of thyroid eye disease are not thoroughly understood, but there are some ways to help prevent it from developing. These include early detection and management of any thyroid dysfunction, as well as management of risk factors for thyroid eye disease, such as smoking.
Smoking has been found to increase the likelihood of thyroid eye disease by seven- to eight-fold. Smoking cessation may also be a recommendation for people with existing thyroid eye disease to help prevent further complications.
Doctors sometimes use radioactive iodine therapy to treat Graves’ disease, but it has also been linked to thyroid eye disease. People with Graves’ disease may want to discuss this treatment with their doctor, especially if they already have eye problems.
There’s no way to prevent glaucoma, so regular eye exams are recommended to allow for early detection if it does occur. Thyroid eye disease could lead to changes in the eye that cause fluid to build up, leading to glaucoma.
It’s not clear how the management of thyroid eye disease affects the risk of developing glaucoma.
An ophthalmologist can usually check for and evaluate the severity of thyroid eye disease just based on examination of the eye and eyelids. They can typically detect it based on the presence of key characteristic features like:
- pain with eye movement
- redness or other color changes of the eyelids or conjunctiva (membrane on the white part of the eye and inside the eyelid)
- reduced clarity of vision
- bulging of the eye
In some cases, imaging of the eye or eye socket may be necessary to gather more information on the severity of the disease and to confirm the diagnosis.
Thyroid eye disease is typically active for
In addition to addressing any underlying thyroid problems that are contributing to the disease, your eye doctor may recommend treatments to help provide relief, improve vision, and prevent further damage, such as:
- cool compresses
- lubricating eye drops or gels (avoid drops with redness removers)
- eyelid taping to prevent cornea formation
- eyelid or eye muscle surgery
- orbit decompression surgery
- medications such as steroids or
teprotumumab (Tepezza), an immunotherapy specifically approved for the treatment of thyroid eye disease in adults - selenium supplements
A doctor may also recommend other types of lifestyle interventions, including:
- smoking cessation
- regular use of sunglasses
- specialized glasses to help with vision changes
- elevating your head when lying down to relieve pressure and prevent swelling
It is possible to manage most cases of thyroid eye disease with lubricating eye drops and lifestyle interventions. Medications may be necessary for a small percentage of people.
Symptoms of thyroid eye disease won’t ever fully go away, but they may get better after the initial active phase of the disease, which lasts, on average, for about
Long-term monitoring with regular eye exams is often advisable to allow for early detection of any complications that may develop, such as glaucoma.
Inflammation in thyroid eye disease can lead to various complications, including glaucoma. While it’s not possible to prevent glaucoma itself, there are various ways to help manage thyroid eye disease and support better eye health.
People at risk for thyroid eye disease, such as those with Graves’ disease or other hyperthyroid disorders, may benefit from regular eye exams to detect any changes in their eye health earlier. If you have any changes in your vision, an ophthalmologist can help determine the cause and identify steps you can take to help protect and preserve your eye health.