Thyroid eye disease is one of the great imitators, with a wide spectrum of symptoms that range from dry eyes to vision loss. Patients often have eyelid retraction (eyelids that are opened wider than normal) and lagophthalmos (inability to close eyes), both of which can result in uncomfortably dry eyes. The eyeballs themselves are often proptotic and protrude unnaturally due to orbital congestion. If the orbital congestion is too severe, patients can have diplopia (double vision) and also damage to the optic nerve can occur, resulting in vision loss and blindness.

Repair consists of strabismus surgery, orbital decompression surgery, and eyelid retraction surgery to help lower the eyelid to their natural positions.