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Treatment of Graves' ophthalmology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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.

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