Something that may seem like a cosmetic problem could be a sign of a serious condition that could lead to blindness.
"My eyes, to me, looked like I was tired all the time, from the shadowing to the swelling," Tina O'Dell said. "My eyes hurt. They felt like something was in it."
O'Dell said she eventually had a horrible throbbing behind her eyes.
"I just didn't feel pretty. I kind of wanted to hide. I started wearing glasses at that time. I had always worn contacts."
O'Dell said she had already been diagnosed with Graves' disease, but in 1998 she was also diagnosed with thyroid eye disease. She had her first surgery that year and seven more later to correct what the disease had done.
"The first thing they may recognize is a little more bags under their eyes, a little bit more fold above the eye," said Dr. Charles Soparkar.
Soparkar is a world-renowned oculoplastic surgeon in Houston. He has treated O'Dell for years.
"Thyroid eye disease is very prevalent," Sopakar said. "One in five patients who come into my practice for cosmetic eyelid surgery has undiagnosed thyroid eye disease. Patients will come in to their plastic surgeon and say, 'Doc, over the last four months, 6 months, all of a sudden I've gotten older. My eyes have changed.'"
He said that should be a huge warning sign. Aging doesn't happen suddenly.
"The earliest sign might be dry eye, redness," he said.
Soparkar makes the diagnosis based on family history, symptoms, a physical exam and, in some cases, a blood test.
Thyroid eye disease is more common in women. People with parents who have it have a 50 percent change of having it. It also runs in families with other autoimmune diseases like rheumatoid arthritis, diabetes, lupus or Crohn's disease.
"If left undetected, it can blind you," Soparkar said.
Soparkar said he has treated more than 6,000 patients with thyroid eye disease and he has never had a patient go blind.
He said milder cases are treated with diet restrictions of salt and alcohol, head elevation at night and medications. More severe cases often require surgery.