allergies banner imageallergies banner image

Thyroid Eye Disease vs Graves’ Disease

TED and Graves’ disease are different conditions that require different doctors and different medicines

If you have Graves’ disease or another thyroid disorder, you may have heard of the eye condition known as Thyroid Eye Disease (TED), which is sometimes referred to as Graves’ Eye Disease.

TED and Graves’ disease are both autoimmune disorders. That means your body’s immune system attacks your own tissue by mistake. In Graves’ disease, your thyroid is affected. When you have Thyroid Eye Disease, it affects the muscle and fat behind your eyes. Watch the video below to learn more about the differences between TED and Graves’ disease, and TED risk factors.

Thyroid Eye Disease vs Graves' disease video preview
Read transcript

Announcer: Thyroid Eye Disease (or TED) is a rare disease affecting the eyes. TED is also referred to as Graves’ Eye Disease. TED can develop in patients with Graves’ disease. Although they are both autoimmune conditions, TED and Graves’ disease are different conditions as they affect different parts of the body. 

In Graves’ disease, the body mistakenly attacks the thyroid glands, resulting in an overactive thyroid, or hyperthyroidism. In TED, the immune system attacks the muscles and fat tissues behind the eyes, causing redness and swelling known as inflammation. This process results in both the muscles and fat tissues behind the eyes expanding, as well as a buildup of fluid. 

Treatments for Graves’ disease are targeted to help the thyroid but won’t help TED. Different medications and specialists are required to manage each condition. Some of the early symptoms of TED are eye pain, redness, dry or gritty eyes, or overly watery eyes, and blurry vision. These symptoms can be mistaken for other conditions, such as allergies. 

TED is a progressive disease, which means it can get worse over time. Bulging eyes and eyelid swelling may occur as TED progresses. Eye swelling can make it hard to move the eyes. All these effects can lead to vision impairment, including double vision. In some cases, it is possible for swelling of fat and muscle tissue to push against the optic nerve, which puts vision at risk. 

While it is not entirely known why some people develop TED and others do not, doctors have found certain factors that put people at greater risk. This includes having a thyroid condition such as Graves’ disease or hyperthyroidism, and Hashimoto’s disease, or hypothyroidism. The risk of developing TED may also be increased if patients have received radioactive iodine as treatment for Graves’ disease. In general, women are more likely to suffer from TED. Smoking and middle age further increase the risk of developing the condition. 

As a rare and complicated disease, TED treatment requires a specialist who is familiar with treating it. Doctors who are most familiar with TED are usually specialized ophthalmologists, such as oculoplastic surgeons, neuro-ophthalmologists, and strabismus surgeons. Remember, TED can get worse over time. Getting treatment as early as possible can help prevent further eye damage. 

Find a TED Eye Specialist at

TED often develops in people who have Graves’ disease. But they are separate conditions that require different treatment. There’s a lot of information about these two conditions, but some of it can be confusing. Scroll on to find out what’s myth and what’s fact.

Expand AllCollapse All

FACT: TED is a different condition from Graves’ disease.

Many people think Graves’ disease and Thyroid Eye Disease (TED) are the same. That’s because people often have both diseases at the same time.

That is also because both are autoimmune diseases. This means your body’s immune system attacks a healthy part of your body by mistake.

If you have Graves’ disease, your body’s immune system attacks the thyroid. If you have TED, your body’s immune system attacks the tissue behind your eyes. This can cause a number of different changes to your eyes.

TED is often called by different names containing the word Graves’ or thyroid, including:

  • Graves’ eye disease
  • Graves’ ophthalmopathy (GO)
  • Graves’ orbitopathy
  • Graves’ disease eyes
  • Thyroid-associated orbitopathy (TAO)
  • Thyroid ophthalmopathy

Get to know the symptoms of TED so you know what to watch for.

Learn more

FACT: You can develop TED without having Graves’ disease.

While it’s true that many people are diagnosed with Graves’ before being diagnosed with Thyroid Eye Disease (TED), it’s not always the case. In fact, about 1 in 10 people with TED develop it without having Graves’ disease.

It’s also not uncommon for people to be diagnosed with TED before, during, or even after getting diagnosed with Graves’ disease.

People diagnosed with TED may also be diagnosed with a different type of thyroid condition called Hashimoto’s disease or Hashimoto’s hypothyroidism (high-poe-thigh-roid-izm).

Questions? Call a Nurse Advocate.

Get answers about TED and help finding a TED Eye Specialist.

Call 1-833-833-3930

Monday through Friday, 8AM to 8PM, ET.

Nurse Advocates do not provide individual patient care or medical advice. After speaking with a Nurse Advocate, be sure to talk to your doctor about any signs or symptoms and treatment options.

FACT: TED affects the eyes. Graves’ disease and Hashimoto’s disease affect the thyroid.

Although “thyroid” is in the name, Thyroid Eye Disease (TED) is an autoimmune condition that affects the muscle and fat tissue behind your eyes, not your thyroid. It causes this tissue to swell, which can make your eyes bulge and cause other symptoms.

Learn the common symptoms of TED

Unlike TED, Graves’ disease affects the thyroid, causing its own set of changes, such as a fast or irregular heartbeat or anxiety.

Learn more about Graves’ disease symptoms

Hashimoto’s disease also affects the thyroid and has its own set of common symptoms.

FACT: TED and Graves’ disease need different treatments.

Medicine for Graves’ disease won’t work for Thyroid Eye Disease (TED), and medicine for TED won’t work for Graves’ disease. That’s because TED and Graves’ disease are different conditions and need different medicines.

Graves’ disease affects the thyroid, while TED affects the eyes. So, for Graves’ disease, you should see a doctor who specializes in the thyroid: an endocrinologist. For Thyroid Eye Disease, you should contact a Thyroid Eye Disease Specialist, who is usually an ophthalmologist with advanced training and experience treating TED.

Graves’ disease treatment:

TED treatment:

  • Doctors may use other types of medicines to treat your eye symptoms and/or surgery to help fix your eyes

Learn more about treatment options

If you have TED, there’s a treatment option available that doesn’t require steroids or surgery.

FACT: If you have TED, you should see an ophthalmologist who has experience treating TED.

Thyroid Eye Disease (TED) is a unique and rare eye condition, and not all doctors are used to treating it. That’s why it’s important that you see a doctor who has the right experience—a TED Eye Specialist.

TED Eye Specialists are ophthalmologists who usually have advanced training, such as oculoplastic surgeons, neuro-ophthalmologists, and strabismus surgeons.

While there are about 20,000 eye doctors in the US, most are not used to seeing TED patients. TED Eye Specialists have advanced training in specific types of eye and vision care.

Learn more about TED Eye Specialists

TED is rare and requires an expert doctor.
Make sure you contact a TED Eye Specialist to get the right kind of care.

Find a TED Eye Specialist

FACT: Thyroid conditions and TED need to be treated by different doctors. You should see an endocrinologist for Graves’ disease or other thyroid conditions, and a TED Eye Specialist for TED.

Graves’ disease and Thyroid Eye Disease (TED) affect different parts of the body. Graves’ disease affects the thyroid and should be managed by an endocrinologist, who is an expert in treating thyroid issues.

TED is a separate disease that affects the eyes and should be managed by a doctor experienced in treating it: a TED Eye Specialist. There are a few different types of eye doctors who can be TED Eye Specialists.

If you have both conditions, your endocrinologist and your TED Eye Specialist should stay in regular contact with each other. They need to work together to make the best treatment plan for you.

If you suspect you may have Thyroid Eye Disease, see a TED Eye Specialist and ask for a baseline eye exam.

Contact a TED Eye Specialist

FACT: The sooner TED is treated, the better. TED may cause serious eye damage.

Thyroid Eye Disease (TED) is an ongoing condition with 2 phases. If left untreated, TED may get worse over time.

Phase 1: “Acute” TED (also called “Active” TED)
During the “acute” phase, symptoms appear suddenly and can get worse quickly. Inflammation (redness and swelling) and scarring can start to damage your eyes. Because of this damage, you may notice symptoms like eye pain, redness, swelling, eye bulging, double vision, and misaligned eyes. The acute phase usually lasts between 6 months to 2 years.

Phase 2: “Chronic” TED (also called “Inactive” TED)
Over time, TED changes to the “chronic” phase where scarring and damage continue. During this phase, some symptoms may get better—like redness and swelling. But others may not go away—like eye bulging, double vision, misaligned eyes and eye pain. If left untreated, some symptoms may return, or “flare up.”

Spot TED symptoms, avoid serious damage

Keeping track of your symptoms––and talking with your doctor right away about any changes––can have a big impact. Speak up for the care you deserve.

Observe and track your TED symptoms

Gail page RTD Gail page RTD Gail page RTD

Can you be faster than Gail in getting a diagnosis for Thyroid Eye Disease?

Take part in the Race to Diagnosis game to see if you can beat Gail.