Thyroid Eye Disease

Problems in the thyroid gland’s function may lead to changes in the eye and orbit (eye socket). The combination of thyroid dysfunction and eye changes is known as Graves’ disease or thyroid eye disease (TED). Typically, the eye symptoms occur when thyroid hormone levels are too high but can occur when these levels are normal or below normal.  It is characterized by swelling and inflammation of tissue within the orbit. This may elevate pressure behind the eye resulting in protrusion of the eye, double vision and possible damage to the optic nerve.  Patients may also have large openings to their eyes.

Thyroid eye disease symptoms can include

  • Protrusion of eye
  • Large opening to eyelids
  • Sandy sensation
  • Dryness
  • Double vision
  • Pressure sensation
  • Decreased vision


Thyroid eye disease treatment depends upon the severity of the disease. Artificial tears and ointment are used to treat dry eye symptoms. Certain cases may require steroid therapy, surgery for eyelids or eye muscles, orbital decompression surgery or radiation.

Excessive Skin/Puffiness Of The Eyelids

Several factors such as aging, sun damage, smoking and stretching can cause the eyelids to droop and sag as the supporting tissues deteriorate, and even cause the appearance of swollen or puffy eyelids. This area is often one of the first to deteriorate, as the skin of the eyelid is thinner than the rest of the face.  This can result in an older, more tired appearance.

Symptoms Can Include

  • Puffiness above or below the eyes
  • Droopiness of the eyelids
  • Tired appearance


Treatment typically involves surgery to rejuvenate the eyelids and face.