
Graves' Disease Support Group
Graves-Basedow disease is a medical disorder that may manifest several different conditions including hyperthyroidism (over activity of thyroid hormone production), infiltrative exophthalmos (protruberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). This disorder is the most common cause of...
1) What causes the bulging eyes?: Enlargement of the extraocular muscle bodies and expansion of the orbital fatty connective tissues is apparent in patients with Graves Opthalmopathy (GO)
2) The clinical symptoms and signs of GO (The bulging eyes) can be explained mechanically by the discrepancy between the increased volume of the swollen orbital tissues and the fixed volume of the bony orbit.
3) The expanded orbital tissues displace the globe forward and can block venous (blood) outflow from the orbit. These changes along with the local production of cytokines and other mediators of inflammation, result in pain, proptosis (bulging), periorbital edema, conjunctival injection (redness), and chemosis (swelling of the conjunctiva)
4) Who gets it?: Clinical involvement of the eyes develops in 25% to 50% of individuals with Graves disease. Smoking appears to increase the risk of GO. The annual incidence of Graves ophthalmopathy (GO) in women is approximately 16 in 100,000 and in men three in 100,000.
5) 5% of patients with GO have SEVERE ophthalmopathy, including excessive chemosis (swelling of the conjunctiva), proptosis, or even loss of vision.
6) What can be done for serious eye disease other than treating your Graves? : Surgery for GO in severe cases includes transcaruncular approach orbital decompression (can you believe that name) which effectively treats compressive optic neuropathy
7) As the mechanism of Graves ophthalmopathy (GO) becomes clearer, targeted immunomodulating therapy (remicade, humira, enbrel, etc) should allow for successful treatment. Further research should compare new agents to surgery in order to minimize the morbidity associated with any surgical approach.
Dr O.
You can still get the "bulging eyes" after treatment is initiated for Graves but that is unusual.
Dr O.
I have been on treatment for grave's for 8 months, and just this past week my right eye has BULGED out of it's socket.
Before I was diagnosed my right eye was protruding a little bit, but once I started meds it went back to normal.
Now, over this past week I have been dealing with INTENSE personal stress over divorce/custody and my eye looks GARGANTUOUS!..and it's only my right eye so it looks even MORE un-natural!!!
Now that my stress has gotten the best of me....does anyone know if my eye will settle back into place, or once it's "popped" it's popped?
M~