Graves ophthalmopathy, or thyroid eye disease, is an autoimmune condition in which inflammation and swelling of orbital tissues cause characteristic eye changes, most often in people with Graves hyperthyroidism.
Ocular Manifestations
Enlarged extraocular muscles and orbital fat push the eyes forward and restrict movements.
- Common signs include proptosis, eyelid retraction, exposure symptoms, and varying degrees of double vision.
- Severe cases can compress the optic nerve, leading to colour desaturation and visual loss.
- Dryness, grittiness, and watering are frequent due to increased exposure and reduced blinking.
- Smoking significantly worsens the disease and impairs treatment response.
Treatment
Management depends on disease activity and severity, combining ocular lubricants, systemic immunosuppression, radiotherapy, and staged surgery when needed.
- Active inflammatory disease may be treated with steroids, biologics, or other immunomodulators.
- Once stable, orbital decompression, squint surgery, and eyelid procedures can improve function and appearance.
- Close coordination between endocrinologists and eye specialists is essential.
- Regular monitoring of optic nerve function helps detect compressive neuropathy early.
