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Thyroid Eye Disease (Graves' Ophthalmopathy)

Inflammation of the orbital and ocular muscles associated with Graves' disease.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Thyroid Eye Disease (Graves' Ophthalmopathy)?

Graves' ophthalmopathy (thyroid eye disease) is an autoimmune eye disease associated with Graves' disease, characterized by inflammation and enlargement of the retrobulbar fat and ocular muscles. Clinically apparent eye involvement develops in 25-50% of patients with Graves' disease.

TSH receptor antibodies (TRAb) play a central role in the pathogenesis. The disease has two phases: an active inflammatory phase and an inactive fibrotic phase. The Clinical Activity Score (CAS) is used to assess disease activity.

Teprotumumab (an IGF-1R blocker) is the first FDA-approved targeted therapy that significantly reduces proptosis and diplopia in moderate-to-severe Graves' ophthalmopathy. Vision-threatening cases (optic neuropathy, risk of corneal perforation) require urgent intervention.

Symptoms

Proptosis (forward bulging of the eyeballs)
Eyelid retraction and periorbital edema
Eye redness and dryness
Diplopia (double vision)
Pain and pressure behind the eye
Vision loss (optic neuropathy — serious complication)

Risk Factors

Graves' disease
Smoking (the strongest modifiable risk factor)
Radioactive iodine therapy (risk of worsening ophthalmopathy)
High TRAb
Male sex (more severe course)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If eye swelling and proptosis develop
  • If diplopia occurs
  • If vision loss begins (emergency)
  • If the eyelids do not close completely

Treatment Methods

01
Smoking cessation (the most important preventive step)
02
Selenium supplementation (in mild cases)
03
IV methylprednisolone pulse therapy (in active moderate-to-severe cases)
04
Teprotumumab (IGF-1R blocker — for proptosis and diplopia)
05
Orbital decompression surgery (in vision-threatening cases)
06
Strabismus and eyelid surgery (in the inactive phase)

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.