Thyroid Associated Orbitopathy (TAO)

What is TAO?

Be Eye Wise and find out that 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. Thyroid-associated orbitopathy is associated with Graves’ thyroid disease. It can develop any time during the course of the disease, whether your thyroid is normal, underactive or overactive.

There are two phases of thyroid-associated orbitopathy:

  • Active (inflammatory) phase, which may last from six months to five years. Signs and symptoms change or progress over weeks to months.
  • Non-active (post-inflammatory) phase, which begins once the signs and symptoms have remained stable for at least 6 months.

Symptoms of active thyroid-associated orbitopathy can be:

  • 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.

Symptoms of non-active thyroid-associated orbitopathy can be:

  • Eyelid retraction.
  • Exposure keratopathy.
  • Tightness and pulling sensations when moving the eyes which then causes double vision.
  • Proptosis and compressive optic neuropathy with vision loss.


Treatment of thyroid-associated orbitopathy.

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 thyroid-associated orbitopathy depends on each case but may include a combination of surgery and medicine.

To learn all you can about thyroid orbitopathy, Be Eye Wise and schedule an appointment with Northwest Eye orbitopathy specialist Dr. Nicholas Schmitt. Because the more you know, the better you see.