Immunology of Thyroid Eye Disease

Thyroid Eye Disease (TED) is the most common orbital disease, affecting 50%-60% of patients with Graves' hyperthyroidism.1 Although clinical symptoms and signs are usually mild, consisting of mild ocular irritation, periorbital swelling, and lid retraction without visual compromise, the disease can be severe in approximately 15% of cases, resulting in exposure keratopathy, diplopia, and optic neuropathy. To date, there is no ability to predict which patients will develop the severe form of the disease, although age over 50, male gender, smoking, and microvascular disease are known risk factors.