Grave’s ophthalmopathy or thyroid eye disease commonly affects individuals with Graves’ disease which is an autoimmune disorder of the thyroid gland. This condition can affect the tissues and muscles around the eyes and eyelids. Some of the main types of thyroid eye disease are:

Proptosis – It refers to the bulging out or protrusion of the eyes from their sockets. Increased fat or swelling behind the eyes causes the eyes to appear prominent.

Diplopia – It is double vision or seeing two images of a single object. It occurs when the extraocular muscles that control eye movements get inflamed and swollen.

Eyelid retraction – The eyelids can retract upwards and not fully close due to swelling of the muscles that close the eyelids.

Dry eyes – The lacrimal glands responsible for tear production may get inflamed leading to dry, gritty or painful eyes.

Orbital congestion – Swelling of the tissues behind the eyes causes pressure and fullness in the eye area.

Inflammation of extraocular muscles

The extraocular muscles surrounding the eyes that control eye movements can get severely inflamed in Thyroid Eye Disease Treatment. This happens due to infiltration of white blood cells and accumulation of glycosaminoglycans within the muscles. Some key facts:

– The four rectus muscles moving the eyes left-right and up-down are commonly affected.

– Inflammation causes the muscles to swell and enlarge restricting normal eye movements.

– It leads to double vision, vertical or oblique misalignment of eyes.

– Severe inflammation can cause permanent damage to eye movement if not treated on time.

Treatment options for thyroid eye disease

Eye drop lubrication

Lubricating eye drops are used to artificially moisturize dry eyes caused by lack of tear production. Preservative-free drops like Refresh, Systane help relief irritation, burning sensation and promote comfort. They are used 2-6 times daily.

Corticosteroids

Anti-inflammatory corticosteroid medications in the form of eye drops, ointments or oral tablets are the first line treatment for reducing swelling and inflammation of extraocular muscles and eyelids. They work by suppressing the immune system. Common drugs include prednisone, dexamethasone.

Orbital radiotherapy

Low dose radiation therapy is effective for active, moderate to severe cases of thyroid eye disease to reduce inflammation and edema formation. It involves targeting the orbit with precise external beam radiation over weeks to prevent progression and threaten vision.

Surgery

Corrective eye muscle surgery called strabismus surgery helps realign misaligned eyes via adjustment or resection of extraocular muscles for binocular single vision. In severe proptosis, decompression surgery can be done to remove fatty tissue behind the eyes to reduce bulging. Eyelid surgery may be required for retraction or scarring.

Medical therapy

In addition to steroids, newer medications that target the autoimmune process are being used. Biologics like rituximab work as immunosuppressants while teprotumumab specifically blocks the IGF-1R receptor fundamental to the pathogenesis of Thyroid Eye Disease Treatment.

Promising research

Advanced treatments under study include infraorbital injections of corticosteroids guided by CT scans to precisely deliver medication, use of monoclonal antibodies against autoantibodies and autoantigen specific immunotherapy. Stem cell therapy also shows potential in reducing inflammation, scarring and replacing damaged tissues.

With a careful multi-disciplinary approach combining the above medical, radiation and surgical treatment modalities as per individual severity and response, thyroid eye disease can be effectively managed and further complications prevented. Early detection and intervention gives best chance of good outcome and preservation of vision and quality of life.

*Note:
1.  Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it