At-Home Testing
There are no official self-checks or at-home tests that can diagnose thyroid eye disease. You have to see a healthcare professional who can do clinical tests to receive an accurate diagnosis. However, understanding your symptoms and checking for some of them at home can help you communicate with your healthcare provider better.
Check for the following symptoms of thyroid eye disease:
Bulging or protruding eyesDry, red, sensitive, and irritated eyes Vision changesPain or pressure in your eyesProblems moving your eyesWatery eyes
Talk to your healthcare provider if you have any of these symptoms or other vision changes.
Physical Examination
You may begin the process by seeing your primary care physician if you are not diagnosed with hyperthyroidism or Graves’ disease already. Your healthcare provider will do a thorough physical examination. After the initial exam, your primary care physician may recommend seeing a specialist for more testing. You may need to see an:
Ophthalmologist to check your eyes Endocrinologist to check your hormone levels Internist to check your hormone levels
Physical Exam for the Thyroid
During a physical exam, your healthcare provider will:
Touch (palpate) your neck to see if the thyroid is larger than normal or if there are nodules. Check for increased blood flow in the thyroid, called a thrill, by palpating the area. Use a stethoscope to listen to the sound of increased blood flow in the thyroid, called a bruit.
The physical exam may also include checking your:
ReflexesHeart rate and rhythm Blood pressureBody temperature SkinNailsHair FaceTremors or shakingWeight
Eye Exam
You will need a complete eye examination. An eye doctor can do the following:
Test your vision Test your color vision Test visual fields Do eyelid measurementsCheck eye pressure readingsCheck the optic nerves
The eye doctor can also measure the degree of eye bulging with a device called an exophthalmometer. It can show how far forward your eyes have moved because of thyroid eye disease.
Labs and Tests
If you do not have a diagnosis of Graves’ disease already, your healthcare provider may order laboratory tests to confirm it first. However, you may not need these tests if you know that you have Graves’ disease.
You may need blood tests to check the levels of:
Thyroid-stimulating hormone (TSH)Thyroxine (T4) Triiodothyronine (T3) Thyroid-stimulating immunoglobulin (TSI) Thyroid-stimulating hormone receptor antibody (TRAb)Anti-thyroid peroxidase antibody (anti-TPO)
Imaging
If you do not have a diagnosis of Graves’ disease already, you may have the following imaging tests:
Radioactive iodine uptake test with X-rays to check how the thyroid collects iodine Ultrasound of the thyroid to see if it is enlarged or has nodules CT scan to check for an enlarged thyroid and nodules MRI to check for an enlarged thyroid and nodules
If you know that you have Graves’ disease, you may have the following imaging tests to check the condition of your eyes and eye muscles:
CT scanMRI
Differential Diagnoses
It is possible for some of the symptoms of thyroid eye disease to be similar to other conditions, such as orbital tumors (abnormal growths in the sockets of the eyes). Your healthcare provider will do multiple tests to confirm your condition.
Inflamed tissuesEnlarged musclesCompressed optic nerves in the eyes
By combining the results of a physical exam, lab tests, and imaging tests, your practitioner can determine if you have thyroid eye disease or something else.
A Word From Verywell
Talk to your healthcare provider if you have questions about the diagnosis process. Usually, you will need several tests to figure out if you have thyroid eye disease. The process may take less time if you already have a Graves’ disease diagnosis.
It is important to stay patient throughout the diagnosis process. You may need to see specialists, which can take time. Reach out to friends and family for support so they can help while you wait.
The right diagnosis is important for receiving the correct treatment and preventing complications that may appear from Graves’ disease and thyroid eye disease. You should feel comfortable asking your healthcare providers questions and getting the care you need.
