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Epidemiology of dysthyroid eye disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • clinically evident in 25-50% of patients with Graves' hyperthyroidism - occurs occasionally in patients with Hashimoto's thyroiditis and in those with Graves' disease but no evident thyroid disease.

  • the mean age is 45 years and the female:male ratio is 2:1

  • there is an association with cigarette smoking, as 90% of cases occur in smokers

  • return to normal thyroid function is associated with improvement in the eye disease

  • association with HLA-DR3

  • Graves' hyperthyroidism and Graves' ophthalmology are overlapping, if not concurrent, conditions - many patients with Graves' hyperthyroidism but no clinical eye features can be shown to have evidence of ophthalmological changes with techniques such as orbital MRI - similarly many euthyroid patients with Graves' ophthalmology can be shown to have laboratory evidence of thyroid autoimmune disease.

  • in 85% of patients affected by either Graves' hyperthyroidism or Graves' ophthalmology, the other develops within 18 months.


  • 1) Shine B et al (1990).Association between Graves' ophthalmology and cigarette smoking. Lancet, 335, 1261-3.
  • 2) Tallstedt L et al (1992).Occurence of ophthalmology after treatment of Graves' hyperthyroidism.NEJM, 326, 1733-8.
  • 3) Epstein FH (1993).Pathogenesis of Grave's ophthalmology. NEJM, 329(20),1468-75.

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