Graves Disease

Graves’ disease is an autoimmune disease. It most commonly affects the thyroid gland causing goiters, increased heart rate, muscle weakness, disturbed sleep, and irritability. It also affects other systems of the body, including the skin, heart, circulatory and nervous systems.

In the eyes and orbital region, Graves is associated with a set of symptoms commonly referred to as Graves’ ophthalmopathy.

Roughly 50% of those with Graves’ disease suffer from Graves’ ophthalmopathy. In Graves’ ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes. The resulting signs and symptoms may include:

  • Bulging eyes
  • Excess tearing
  • Dry, irritated eyes
  • Gritty sensation in the eyes
  • Pressure or pain in the eyes
  • Puffy eyelids
  • Reddened or inflamed eyes
  • Light sensitivity
  • Double vision
  • Limited eye movements, resulting in a fixed stare
  • Blurred or reduced vision (rare)
  • Ulcers on the cornea (rare)

Treatment for thyroid eye disease generally occurs in two phases. The first phase involves treating the active eye disease. This active period usually lasts two to three years and requires careful monitoring until stable. Treatment during the active phase of the disease focuses on preserving sight and the integrity of the cornea as well as providing treatment for double vision when it interferes with daily functioning and becomes bothersome.

Most patients experience relief from dry eyes by using artificial tears throughout the day and gels or ointments at night. Dryness occurs because the lids are retracted and cannot blink properly, because the tear-producing glands have been affected by the autoimmune process and aren’t functioning well, and/or because the forward bulging of the eyes prevents them from being completely covered by the lids. Surgical decompression can also be used during the active phase, most often to relieve optic neuropathy. It is also helpful in reducing congestion, redness, pain, and ocular exposure.

Treatment during the remission phase that lasts indefinitely in most cases, involves correcting unacceptable permanent changes that persist after the ocular conditions of the active phase have stabilized. Treatment of permanent changes may require surgery to correct double vision and reduce eyelid retraction. Surgery may be helpful in returning the eye to a normal position within the socket (orbital decompression).

Dr. Shifrin performs orbital decompressions, muscle rebalancing and eyelid surgeries for the treatment of Graves’ disease. If you would like to learn more about Graves’ disease treatment, click here to request a consultation with Dr. Shifrin today. Alternatively you can call our office at (312) 590-3572 to schedule your appointment.

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