Gary Joseph Lelli, MD, of the Department of Ophthalmology at Weill Cornell Medicine, discusses the difference between thyroid eye disease (TED) and Graves’ disease by highlighting the signs and symptoms of TED. 

TED is a rare autoimmune disease causing permanent facial disfigurement which can severely affect patients’ quality of life and daily function. TED is most often associated with Graves’ disease, but also can occur in association with hypothyroidism, euthyroidism, and Hashimoto’s thyroiditis. Graves’ disease affects approximately 1% to 2% of the adult population, with an estimated 20-50% of Graves disease patients subsequently developing TED over the course of their lifetime.

As Dr. Lelli explains, Graves’ disease and TED involve separate autoinflammatory processes with Graves’ disease being associated with hyperthyroidism while TED is associated with inflammation of the orbit. The most common sign of TED is retraction of the eyelid which can lead to dryness, blurred vision, and redness in the eye. Two more common symptoms are proptosis and double vision, both caused by the inflammation of the muscles behind the eye. 

Dr. Lelli emphasizes that Graves’ disease and TED are different diseases and require different specialists. Graves’ disease requires an endocrinologist while TED requires an oculoplastic specialist and a neuro-ophthalmologist. To find a specialist – and to learn more about TED in general – go to which has a tool to search for specialists by zip code. 

For more information about TED and other rare eye disorders, visit