treatment of Graves' ophthalmology
Last reviewed 01/2018
Ophthalmologic features may resolve as any attending hyperthyroidism is treated. Symptomatic relief may entail methylcellulose eye drops for sore eyes.
Long term treatment may be necessary for progressive ophthalmology:
- shrinkage of orbital soft tissue - oral corticosteroids, cyclosporin. But high dose steroids eg. prednisolone have inevitable side effects and so are reserved for acute inflammation and optic neuropathy; cyclosporin may cause hypertension, renal failure, and lymphoma
- orbital radiotherapy - may control external soft tissue swelling, injection, and orbital pain. Of value only when used in conjunction with corticosteroids
- surgical decompression - for severe congestive orbitopathic neuropathy; one or more orbital walls including the roof may be removed depending on the approach. Followed by correction of muscle dysfunction.