The muscles cannot be seen, but the swelling causes the protrusion and staring appearance of the eyes. For some people TED has devastating effects because of the physical discomfort and visual disability. The disease also has serious psychological effects because of the altered facial appearance which undermines self-confidence to the extent that some sufferers become socially isolated and experience difficulties coping at work and in their home. All patients with Graves' disease and TED should have regular thyroid checks to ensure that the function of the thyroid gland is maintained as normal as possible. All patients with TED should be encouraged to stop smoking as smoking probably makes the eye disease worse.
Most patients get better with time and simply require reassurance.
Severe cases should be referred to a specialist centre for further assessment and treatment. High doses of steroids, radiotherapy or an operation may be offered if there is severe inflammation, particularly when the disease appears to be getting worse rather than better with time.