Orbital
How thyroid eye disease is treated in stages — supportive care, active-phase medical therapy including Tepezza, and rehabilitative surgery once the disease is stable.
Medically reviewed by Jon Caster, MDOculoplastic SurgeonLast updated June 2026
Part of our complete guide to Thyroid Eye Disease (TED) — this page covers TED treatment in depth.
There is no single treatment for thyroid eye disease — the right plan depends on two things: the phase of the disease (active and inflamed vs. stable and burned-out) and its severity. Mild disease is managed conservatively; moderate-to-severe active disease calls for medical therapy such as Tepezza; and sight-threatening disease is an emergency. Identifying where a patient falls on this spectrum is what determines treatment.
Treatment is guided by the disease-activity score and severity grading — see Signs, Symptoms & Diagnosis.
Almost every patient with thyroid eye disease has some degree of ocular-surface irritation — from a combination of lid retraction, proptosis, incomplete blinking, and inflammation that leaves the cornea exposed. Managing these symptoms is the foundation of care at every severity:
During active inflammation, medical therapy aims to calm the disease and shrink the swollen orbital tissues. Tepezza® (teprotumumab) is an IGF-1R inhibitor infusion and the first drug FDA-approved specifically for thyroid eye disease — it directly reduces proptosis, double vision, and inflammation. Like any infusion it has potential side effects, including elevated blood sugar (important to monitor in diabetics) and hearing changes such as tinnitus or hearing loss that may be permanent; it is avoided in pregnancy. Your team will review these risks before treatment. Corticosteroids (often intravenous) and, in selected cases, orbital radiotherapy are also used.
Read the full guide — mechanism, infusion schedule, trial results, candidacy, and before/after photos — on the dedicated Tepezza® (Teprotumumab) page.
Once the disease has been stable for roughly six months, surgery corrects the changes the active phase left behind. It is performed in a specific order, because each step can change what the next must correct:
The single most important thing a patient can do at every stage is to stop smoking — it is the strongest modifiable risk factor for severe disease and a poorer response to treatment.
Schedule a consultation with Jon Caster, MD to learn if this procedure is right for you.
