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The first step is the regulation of thyroid hormone levels. Topical lubrication of the eye is used to avoid corneal damage caused by exposure. Corticosteroids are efficient in reducing orbital inflammation, but the benefits cease after discontinuation. Corticosteroids treatment is also limited because of their many side effects.
Thyroid-associated ophthalmopathy (TAO), or thyroid eye disease (TED), is the most common extrathyroidal manifestation of Graves' disease. It is a form of idiopathic lymphocytic orbital inflammation , and although its pathogenesis is not completely understood, autoimmune activation of orbital fibroblasts , which in TAO express the TSH receptor ...
A sense of irritation, discomfort, or pain in the eyes. A tingling sensation behind the eyes or the feeling of grit or sand in the eyes. Excessive tearing that is often made worse by exposure to cold air, wind, or bright lights. Swelling or redness of the eyes. Stare; Lid lag (Von Graefe's sign) Sensitivity to light; Blurring of vision
TED causes inflammation and damage to the tissues around the eye and usually occurs in people with Graves' disease, an immune system disorder that results in overproduction of thyroid hormones.
A major expected side-effect of radioiodine in people with Graves' disease is the development of lifelong hypothyroidism, requiring daily treatment with thyroid hormone. On occasion, some people may require more than one radioactive treatment, depending on the type of disease present, the size of the thyroid, and the initial dose administered.
However, deprescribing may be considered if a patient experiences side effects like rapid heart rate, anxiety, or bone loss, or if their thyroid function tests normalize.”
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