Graves' Ophthalmopathy Treatment
Graves' ophthalmopathy is a condition that that presents in patients with Graves' disease, an autoimmune disorder that typically affects the thyroid and sometimes the skin on the lower legs. Not all patients with Graves disease will experience Graves' ophthalmopathy--according to the New York Thyroid Center, many patients with thyroid disorders won't experience eye disease, and some will be affected only mildly. However, when Graves' ophthalmopathy is present, medical treatment depends on the patient's needs and severity of symptoms.
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What Causes Graves' Ophthalmopathy?
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Graves' disease is typically associated with a condition called hyperthyroidism--an overactive metabolism. However, unlike hyperthyroidism caused by other conditions such as thyroid nodules or thyroiditis, Graves' disease also has an autoimmune component: antibodies attack the thyroid gland which in turn cause it to overproduce thyroid hormone. According to the Mayo Clinic's Rebecca Bahn, M.D., the same antibodies that affect the thyroid also launch an attack on the tissue behind the eyes that pushes the eyeballs out of their orbital socket. Graves' ophthalmopathy can still affect patients with Graves' disease--even when they're had their thyroid ablated or surgically removed. Patients with Graves' opthalmopathy may note a host of eye symptoms, including excessive tearing, red eyes, swollen eyelids, light sensitivity, having the sensation of having sand in one or both eyes, double vision, and a marked space between the eyes and eyelids.
Oral Steroids
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Some symptoms of Graves' ophthalmopathy can be reduced with prescription oral corticosteroids such as prednisone. These medications provide temporary relief from pain, swelling and irritated eyes; however, the side-effects caused by these drugs preclude them from long-term use.
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Special Glasses
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For patients with Graves' ophthalmopathy who experience double vision (diplopia), wearing glasses with special prism lenses may be helpful. These can be worn while the patient is waiting for spontaneous improvement in his or her condition, or while awaiting surgical correction of the condition.
Invasive Treatments
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Sometimes surgical intervention is necessary when Graves' ophthalmopathy is severe. Orbital decompression surgery may be required in order to allow the eyes to return to their normal position in the eye sockets. In some cases, the inflammation of eye tissue causes the muscles to be too short to allow the eyes to properly align, in which case surgery on the eye muscles may be required. Orbital radiotherapy--a less invasive procedure that uses X-rays to destroy some of the eye tissue--was once a common treatment. However, according to the Mayo Clinic, studies suggests that it provides little relief for those with mild to moderately severe symptoms, although it may be helpful when symptoms are getting worse or oral steroids are ineffective.
Treatment at Home
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Graves' ophthalmopathy does resolve with time--anywhere between a few months and a few years. Patients who experience only very mild symptoms may find success using over-the-counter treatments and making adjustments in lifestyle. Use of lubricating eye drops frequently reduces dryness and irritation, and wearing wrap-around dark sunglasses relieves light sensitivity. Patients may find they experience less swelling of the eyelids by sleeping with their heads slightly elevated at night. A room humidifier can also help prevent dryness of the eyes.
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