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Thyroid eye disease (bulging eyes)

Also called: Thyroid eye disease, Graves' eye disease, bulging eyes

Immune swelling behind the eyes, usually with Graves' disease, causing bulging, dry, red eyes and sometimes double vision.

TreatmentLubricants, selenium, teprotumumab, surgery

Overview

Smoking makes it worse.

The immune system swells tissue behind the eyes.

It often comes with Graves disease.

Symptoms

Common signs:

  • Bulging, red eyes

Less common

  • Double vision
  • Gritty eyes

When to get medical care

Call 911Sudden vision loss, a curtain over vision, or a painful red eye with vision changes: go to the ER.
Get care todayVision dimming or color changes.
See a doctor soonSymptoms that last or keep coming back.

Causes

Immune.

Does it spread or run in families?

  • It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

  • Graves' disease
  • Smoking

Diagnosis

A clinician asks about your symptoms and may order tests.

The exam

A physical exam.

Tests

Tests, if needed:

  • Eye exam:
  • CT or MRI:

Treatment

Treatment depends on the cause and how severe it is.

Self-care

  • Stop smoking
  • Lubricating drops
  • Sunglasses

Prevention

To lower your risk or prevent problems:

  • Don't smoke

Which doctor treats this

  • Start with your primary care provider (family doctor or internist).
  • They may send you to an ophthalmologist (eye doctor and surgeon) or an optometrist.

Living with it

  • Take thyroid pills the same way every day, often on an empty stomach.
  • Get blood tests as advised.
  • Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

Back to school, work, or sports

  • Most people can keep working or going to school.
  • Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

  • Smokers: Higher risk and worse disease.

Pregnancy and breastfeeding

  • If you're pregnant or planning to be, tell your prenatal provider about this condition.
  • This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
  • Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
  • Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
  • Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

  • Go to visits when you can and take notes.
  • Keep a list of medicines, allergies, and doctors in one place.
  • Learn the warning signs that need fast care.
  • Take breaks and ask for help. Caregivers need care too.

Outlook

Outlook depends on the cause; early care helps.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

  • A list of your medicines and supplements
  • Notes on when symptoms started and what makes them better or worse

Questions to ask

  • What's causing this?
  • What treatment do you recommend?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Thyroid eye disease (bulging eyes)

Sources

Last updated 2026-11-12.