Graves’ ophthalmopathy, also known as Graves’ eye disease, represents the most frequent non-thyroidal manifestation of Graves’ disease. Both conditions are chronic diseases with physical and psychological symptoms ranging from no manifestations to severe manifestations. Graves’ ophthalmopathy affects the orbit around the eye, resulting in symptoms such as upper eyelid retraction, lid lag, swelling, redness, conjunctivitis, and bulging eyes.
Understanding Graves' Disease
What is Graves' Disease?
Symptoms of Graves' Ophthalmopathy
This eye condition results from an abnormal increase of fat tissue within the orbital cavity and the overdevelopment of the eye muscles. Since the eye socket or orbit is rigid, inflexible, and cannot accommodate the larger eyeball, the eye bulges out, causing headaches, tearing, and a pressure sensation. The pressure can cause optic neuropathy in extreme cases, leading to vision loss.
- Inflamed eyes
- Itchy eyes (some call them gritty eyes)
- Swelling of the eyelids and tissues around the eyes
- Widening of the space between the eyelids
- Photophobia (sensitivity to light)
- Reddened eyes
- Changes in visual sharpness or color vision
- Abnormal protrusion of the eyeball(s)
- Eye pain
- Severe swelling around the orbit
- Severe restriction of ocular motion
- Corticosteroid dependency
- Excessive or disfiguring protrusion of the eyeball(s)
- Optic neuropathy
- Orbital congestion
- Severe dry eyes
Causes and Risk Factors
Ophthalmopathy occurs in about 50% of Graves’ cases, with severe forms affecting 3 to 5% percent of these patients. Graves’ ophthalmopathy is more frequent in women than men, occurring at a 4:1 female-to-male ratio. Rates of this condition peak from ages 50-70. We offer advanced Grave’s eye disease treatments that can alleviate symptoms and reduce the risk of serious complications. Other risk factors include:
- Family history of Graves’ disease or Hashimoto’s disease
- Pre-existing autoimmune disorders
- Hormonal disorders
- Nicotine use
- Celiac disease
- Pernicious anemia
Diagnosing Graves’ Ophthalmopathy
In the early, active stage of Graves’ ophthalmopathy, the condition can often be treated with non-surgical therapies, such as corticosteroids. When patients do not respond to steroids or other conservative measures, surgical intervention may be beneficial.
Once Graves’ ophthalmopathy becomes chronic, it is often resistant to conservative therapy. The response rate to nonsurgical treatments is about 65%, and most patients’ improvements are modest. Even after successful immunosuppression, most patients have remaining eye changes and require rehabilitative surgery.
Patients with Graves’ ophthalmopathy who visit The Institute for Advanced Reconstruction undergo a thorough evaluation to confirm their diagnosis and determine if they are a candidate for treatment with orbital decompression surgery.
Graves’ Ophthalmopathy Treatments
Orbital Decompression Surgery
The Institute for Advanced Reconstruction offers a unique surgical solution for Graves’ ophthalmopathy that delivers excellent results. Orbital decompression surgery involves removing excess fat from the orbital cavity and expanding the orbital wall to alleviate pressure and congestion in and around the eyes.
Dr. Neven Olivari of Germany first described the technique in 1988. Our very own Dr. Tushar Patel was able to train under Dr. Olivari’s guidance, making him an expert in transpalpebral orbital decompression. Now, Dr. Patel and the IFAR team are proud to be on the cutting edge by providing this advanced treatment option for Graves’ ophthalmopathy.
Orbital decompression surgery may involve fat removal alone or it may include the removal of bone to expand the orbital vault. It often involves a combination of these techniques, depending on the severity and stage of the disease. With Dr. Patel’s expertise, the procedure can improve orbital congestion, pain, eye bulging, and eyelid disfigurement; for extreme cases, it can prevent optic nerve damage, corneal breach, and eye dislocation.
Graves’ Eye Disease: What You Need to Know
Graves’ Ophthalmopathy- Mary Ellen’s Story
Graves’ Ophthalmopathy: Your Questions Answered
Graves’ Ophthalmopathy Treatment – Orbital Decompression
Visit our patient resource page for important forms and information about Graves’ ophthalmopathy treatments
Am I a candidate for Graves’ Ophthalmopathy treatment?
If you are suffering from Graves’ ophthalmopathy, contact us today to find out if you qualify for our advanced orbital decompression surgery.