Thyroid-associated orbitopathy (TAO)

Thyroid-associated orbitopathy (TAO) is the most common specific inflammatory condition affecting the eye socket and periorbital tissues. The muscles that move the eye (extraocular muscles) are the primary site of inflammation, but orbital fat and eyelid muscles are also involved.

TAO is associated with Graves’ thyroid disease. It can develop any time during the course of the disease—whether your thyroid is normal, under-active, or over-active.

There are 2 phases of TAO:

• Active (inflammatory) phase may last from 6 months to 5 years. Signs and symptoms change or progress over weeks to months. Symptoms of active TAO include:
  • Eyelid retraction causing “thyroid stare”
  • Dry eye syndrome
  • Swelling
  • Boggy, wet eyes
  • Restrictive strabismus with double vision
  • Bulging eyes
  • Vision loss from damage to the optic nerve
• Non-active (post-inflammatory) phase begins once the signs and symptoms have remained stable for at least 6 months. Symptoms of the non-active phase include:
  • Eyelid retraction
  • Exposure keratopathy
  • Tightness and pulling sensations when moving the eyes causing double vision
  • Proptosis and compressive optic neuropathy with vision loss.

TAO Treatment

Surgical treatment is typically reserved for the non-active phase of the disease—except when vision is threatened (e.g., optic neuropathy or severe corneal exposure).

Treatment of TAO depends on each case, but may include a combination of surgery and medicine.

If you have thyroid issues or concerns, we recommend routine thorough examinations to monitor your eye health. Contact us to schedule an appointment.