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THYROID EYE DISEASE Grave's Disease
General Information
Thyroid eye disease, or ophthalmic Graves' disease, is a medical condition of unknown cause which is related to abnormal thyroid function and various degrees of eye changes. The earliest eye findings are related to lid changes and mild protrusion of the eye from its normal position in the orbit, or eye socket. This can give the appearance of a constant stare. As the eyelids become less effective in protecting the eye and spreading the tear film, the eye surface may dry and increase in risk for infection. With progression, this can be associated with surface irritation and reflexive tearing. Appropriate use of lubricating eyedrops and ointments are often necessary for comfort and protection.
Inflammation of the orbital tissues is thought to play a role in the signs and symptoms of Graves' disease. Proptosis, or the protrusion of the eyes, is thought to be associated with an inflammation in the orbit that causes swelling, thereby pushing the eyes forward. A related swelling commonly affects the eye muscles that control the direction of eye gaze. This muscular involvement further fills the orbital area and also affects the eye movements, possibly causing double vision.
The medical treatment of Graves' disease may include the use of systemic drugs and/or radioactive iodine treatments; when bulging is severe, surgery may be suggested to protect and improve eye function. The first and primary goal is to ensure a normal level of thyroid gland secretions. However, even when this is accomplished, the eye difficulties may persist or even progress. As a result, all patients with thyroid disease require more frequent examination.
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