Graves’ eye disease (Graves’ ophthalmopathy)

Description Graves' eye dis...

Description

Graves' eye disease (Graves' ophthalmopathy) is an eye disorder associated with an overactive thyroid gland caused by Graves' disease. Up to half of people with Graves' disease develop eye symptoms. Individuals with this disease develop swelling in the tissue, muscles and fat in the eye socket. This swelling can lead to a characteristic protrusion of the eyes called exophthalmos. In some cases, the swelling is significant enough to result in stiffening of the muscles that move the eye and can put pressure on the optic nerve. In these cases, vision can be affected.

Symptoms

Symptoms vary depending on the severity of disease. Early symptoms include dry eyes, tearing, light sensitivity, double vision and forward displacement of the eyes. Later, swelling of the tissue can result in decreased ability to move the eyes and in rare cases, visual loss.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical will be performed. Laboratory studies will frequently be ordered to assess thyroid function. A CT scan or MRI may be performed to better visualize the orbits.

Tests:
Complete blood count (CBC), Thyroid stimulating hormone (TSH), Thyroxine (T4), Triiodothyronine (T3), Thyroid peroxidase (TPO) antibodies

Other Specific Tests: CT scan, MRI

Specialists:
Internal Medicine, Ophthalmology, Endocrinology, Family Practice

Treatment

Treatment varies depending on the severity of the disease. Sunglasses, cool compresses and artificial tears may be sufficient in mild cases. Other cases may require the use of corticosteroids such as prednisone. External radiation of the eye socket has been used but it's benefit has not been proven to be conclusive. Surgery to reposition the eyelids and decompress the orbit (make more room) can be done in more severe cases. If the patient is a smoker, quitting is recommended.