THYROID EYE DISEASE
Thyroid eye disease care for complex eye and eyelid changes.
Evaluation and treatment planning for bulging eyes, eyelid retraction, inflammation, double vision, and TED-related changes.
WHAT TED IS
An autoimmune disease of the orbit
Thyroid eye disease (TED) — also called Graves’ orbitopathy — is an autoimmune condition in which the immune system targets the tissues around and behind the eyes. The muscles and fat within the orbit swell and expand, changing both how the eyes look and how they work.
TED most often accompanies an overactive thyroid, but can also occur when thyroid levels are normal or low. It has an active, inflammatory phase and a later stable phase — and the right treatment depends heavily on which phase a patient is in.
PRESENTING TED RESEARCH · ASOPRS
COMMON SYMPTOMS
How TED shows itself
APPEARANCE
Bulging or protruding eyes · eyelid retraction or swelling · a staring look · changes to facial shape.
COMFORT
Dryness, grittiness, irritation · redness · pressure behind the eyes · difficulty closing the eyes fully.
VISION
Double vision · blurring · rarely, pressure on the optic nerve that can threaten sight and requires prompt care.
The expansion of orbital fat and muscle pushes the eye forward and pulls the eyelids out of position — which is why TED affects appearance, comfort, and vision at once, and why care often involves both medical treatment and, later, surgical repair.
MEDICAL TREATMENT PLANNING
Targeted infusion therapy, for selected patients
For selected patients, targeted infusion therapy can reduce the inflammation, eye bulging, and double vision of TED. Two FDA-approved medicines now target the IGF-1R pathway at the center of the disease. Candidacy depends on disease activity, severity, medical history, and individual risk profile.
Treatment information
8 infusions over about 5 months. Learn what treatment involves and who may be a candidate.
Treatment information
5 infusions over 12 weeks; approved for active and chronic TED. Learn more.
MEDICAL THERAPY RESPONSE
What targeted therapy can achieve
Active thyroid eye disease — proptosis, eyelid retraction, and inflammation — before and after a course of IGF-1R–targeted infusion therapy.
BEFORE · ACTIVE TED
AFTER · IGF-1R-TARGETED THERAPY
Individual results vary. Images are shown for educational purposes and, where applicable, with patient consent. A consultation is required to determine whether a treatment or procedure is appropriate for an individual patient.
SURGICAL TREATMENT PLANNING
When surgery is the right step
When tissue expansion pushes the eye forward or threatens vision, orbital decompression creates space within the bony socket to reposition and protect the eye. Eyelid repositioning and rehabilitative surgery refine comfort and appearance once the disease is stable.
Some patients benefit from a planned sequence — medical therapy first, then decompression, then eyelid surgery — each step making the next smaller and safer. Sequencing is individualized and discussed openly at consultation.
EXPERIENCE
Background that informs care
Dr. Ugradar’s clinical and academic work has focused on thyroid eye disease, including peer-reviewed research on IGF-1R–targeted therapy and involvement in the clinical development of TED treatments. This background informs patient selection and treatment planning; it does not change the standard that treatment is recommended only when likely to help.
Information about thyroid eye disease and treatment options is educational and does not replace an in-person medical evaluation. Treatment recommendations depend on disease activity, severity, medical history, examination findings, imaging, and individual risks and benefits.
Referring a patient with thyroid eye disease or a complex eyelid/orbital problem? Visit the physician referral page so the case can be directed to the appropriate next step.