The characteristic eye signs often make a doctor suspicious that Graves disease is present. Also, blood testing frequently shows abnormal levels of thyroid hormones. These imaging methods can reveal swelling of the eye tissues and muscles in a pattern consistent with thyroid eye disease. Medical control of the thyroid disorder often does not eliminate the eye problems, which may last one or two years longer. It is not possible to predict which patients will develop advanced eye disease.
Some patients tape their eyes closed when they sleep to prevent further exposure.
Severe cases of corneal exposure may need a lateral tarsorrhaphy, an operation that involves stitching part of the eyelids together. Infection and ulceration of the cornea may require frequent use of antibiotics to prevent perforation of the cornea. Double vision may be corrected with the use of prisms attached to glasses, which partly compensate for limited eye movements. Surgery to reposition the eye muscles is recommended for repair of eye muscle imbalance only after Graves disease stabilizes. Steroid medication decreases the inflammation in the eye muscles and orbital tissue.