Hyperthyroidism: Graves' Ophthalmopathy

Topic Overview

Graves' ophthalmopathy is an autoimmune disease that can occur in people with Graves' disease. In Graves' ophthalmopathy the tissues and muscles behind the eyes become swollen. The eyeballs may stick out farther than normal. This can occur before, after, or at the same time as other signs of hyperthyroidism.

Most people who develop Graves' ophthalmopathy have one or more of the following symptoms:

  • Dry, itchy, irritated eyes
  • A staring or bug-eyed look
  • Sensitivity to light; watery, teary eyes; and a feeling of pain or pressure around the eyes
  • Difficulty closing the eyes completely
  • Double vision, especially when looking to the sides
  • Pain when moving the eyes up and down and from side to side

You will likely have an eye exam to make sure you do not have another eye problem, such as a tumor.

To help reduce dryness and discomfort, your doctor will treat your symptoms of Graves' ophthalmopathy. He or she will use artificial tears, medicated eyedrops, and protective glasses or sunglasses. If the condition is diagnosed early, you can use nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, to relieve pain and inflammation. Be safe with medicines. Read and follow all instructions on the label.

Treatment will depend on how severe your symptoms are. Treatments may include corticosteroid medicines, immunosuppressants, radiation therapy, thyroid surgery, or eye surgery.

Ophthalmopathy may get worse if your thyroid levels are out of balance. It may also get worse temporarily if you are given radioactive iodine therapy.

Smoking increases your chances of developing Graves' ophthalmopathy. And it can make the condition worse.

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References

Other Works Consulted

  • Ross DS, et al. (2016). 2016 American Thyroid Association guidelines for the diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid, 26(10): 1343–1421. DOI: https://doi.org/10.1089/thy.2016.0229. Accessed September 1, 2017.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer David C.W. Lau, MD, PhD, FRCPC - Endocrinology

Current as ofFebruary 22, 2018