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WHAT CAUSES GRAVES DISEASE?
Grave's disease is not caused by an overactive
thyroid gland. The exact cause is unknown, however,
an autoimmune component has been suggested. Normally,
the immune system uses antibodies to help protect
itself against viruses, bacteria and other foreign
substances that invade the body. In Grave's disease
the immune system mistakenly 'attacks' the thyroid
gland and eyes causing some of the disease's symptoms.
WHAT ARE THE SYMPTOMS OF THYROID EYE DISEASE
(TED)?
The most common ocular symptoms include:
• Mild soreness of the eyes
• Grittiness
• Increased watering
• Photophobia (sensitivity to bright lights)
• Feeling of discomfort behind the eyes
especially when looking up or side to side
• Puffiness of the upper eyelid or around
the eyes (baggy eyelids), and can be worse in
the mornings
• Dry eyes or watery eyes
• Double vision- which is a response to
swelling of the eye muscles causing restriction
of eye movement
WHAT ARE THE EFFECTS/SIGNS OF TED?
The effects of TED include:
• Lid retraction- due to tightness of the
eyelid muscles
• Proptosis (protruding eye)- due to orbital
inflammation and eye muscle enlargement
• Corneal exposure- due to the above two
signs
• Optic nerve compression- as a result of
orbital fat inflammation and eye muscle enlargement
causing compression of the optic nerve
• Glaucoma- the pressure in the eye may
become raised
WHAT IS THE TREATMENT FOR TED?
The treatment of TED depends largely on the severity
of signs and symptoms.
• Eyelid Retraction- Lubricating eye drops
may be necessary because of eye exposure and the
dry eye symptoms. Many patients also require taping
the lids shut at night. If the lid remains retracted
it may require surgical correction to lower the
upper eyelid and raise the lower eyelid.
• Proptosis- This may settle without treatment,
but in most circumstances may require medical
management, such as oral steroids or radiotherapy.
Surgery for reducing the proptosis (i.e. orbital
decompression surgery) may be the treatment of
choice.
• Double Vision- This may respond to prisms
but may, with time, require surgery to straighten
the eyes.
• Optic Nerve Compression- Urgent surgery
is generally required though steroids and radiotheraypy
may be adequate to control the compressive problem.
• Glaucoma- Anti-glaucoma eye drops may
be required.
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