Graves' Ophthalmopathy: A Comprehensive Review of Current Evidence and Management Approaches

Abstract

Thyroid ophthalmopathy, also known as Graves' ophthalmopathy or thyroid eye disease, is an autoimmune condition that affects the eyes and is often associated with hyperthyroidism, an overactive thyroid gland. It is characterized by inflammation, swelling, and tissue changes in the muscles and tissues around the eyes, leading to a range of symptoms including bulging eyes, double vision, eye pain, redness, and sensitivity to light. The treatment of thyroid ophthalmopathy typically involves managing the underlying thyroid condition, relieving symptoms, and preventing complications. Corticosteroids, such as prednisone, are commonly used to reduce inflammation and swelling in the eye tissues. They can be administered orally or locally through eye drops or injections. Orbital radiotherapy, a form of radiation therapy, may also be used to reduce inflammation in the eye tissues, particularly in cases where corticosteroids are not effective or not well tolerated. In addition to medical treatments, eye protection measures are important in managing thyroid ophthalmopathy. This may include wearing sunglasses to protect the eyes from exposure to sunlight and using lubricating eye ointments at night to alleviate dryness. If eyelid retraction or swelling is present, eyelid management techniques such as lubricating ointments, taping the eyelids closed during sleep, or using moisture chamber glasses may be recommended to protect the cornea and relieve symptoms. Managing the underlying thyroid condition is also crucial in the treatment of thyroid ophthalmopathy. This may involve medications to regulate thyroid hormone levels, radioactive iodine therapy, or surgery to remove the thyroid gland, depending on the individual case. Surgical intervention may also be necessary in severe cases of eye-related complications, such as double vision or optic nerve compression. Surgical options may include decompression surgery, eyelid surgery, or strabismus surgery to realign the eyes. It's important to note that the management of thyroid ophthalmopathy is typically tailored to the specific needs of each patient and may involve a multidisciplinary approach involving endocrinologists, ophthalmologists, and sometimes surgeons. Regular follow-up and monitoring are necessary to assess the effectiveness of the treatment plan and make any necessary adjustments. In conclusion, thyroid ophthalmopathy is an autoimmune condition that affects the eyes and is often associated with hyperthyroidism. Treatment typically involves managing the underlying thyroid condition, relieving symptoms, and preventing complications. Corticosteroids, orbital radiotherapy, eye protection measures, and surgical intervention may be used as part of the management plan. It's important to work closely with a healthcare professional to determine the most appropriate treatment approach for each individual case.

Received: 14 January 2023 / Accepted: 26 February 2023 / Published: 20 March 2023