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Grave’s Ophthalmopathy – What You Need to Know

  • November 29, 2017
  • RPh on the Go

graves ophthalmopathyGrave’s Ophthalmopathy (GO) is becoming increasingly prevalent. Grave’s Disease is an autoimmune thyroid disease that can result in ophthalmopathy. In short, ophthalmopathy is an inflammatory disorder of the orbit. Although Grave’s Disease often occurs first, GO can sometimes occur first. Regardless of which occurs first, many patients will experience both rather than just one disorder or disease.

What Are the Symptoms?

There are common symptoms that can be misdiagnosed as another issue. Eye inflammation and eye redness are most common and can be due to other issues or overlooked as being Grave’s Ophthalmopathy. Dryness and/or grittiness to the eye area is another common symptom that could be just about anything else. What you really want to look for are the bulging of the eyes, retracted eyelids, pressure or pain of the eyeball, light sensitivity, and double vision or vision loss. Not all patients have all of these symptoms, but if they have a majority, you can certainly suggest they have their thyroid checked to see if it leads them to a diagnosis of ophthalmopathy.

What Treatments Are Available?

Treatment will widely vary based on the condition of the thyroid and the severity of the disorder. Many patients are treated for the hyperthyroidism first as it can reduce the symptoms greatly. The most serious of cases will face surgery to remove the thyroid and go on hormone replacement therapy. For those who are not as serious, or those that don’t want to go straight into surgery, they will be prescribed medications to slow the overactive thyroid and block the effect of the hormone in their body. Other patients may endure radioiodine therapy and ingest radioiodine to kill those overactive thyroid cells. All of these options can lower the effect of the inflammation of the orbit as the thyroid is under control.

In some cases, treating the thyroid may not be enough or a doctor may decide to treat both conditions at once. Many are prescribed corticosteroids to reduce the swelling behind the eyes. In severe cases, your patient may need surgery to make room for the swollen tissue, realign the weak eyes, or to correct the retracted eyelids.

How Can I Help?

Pharmacists and physicians should watch your patients carefully, if they are purchasing a lot of eye drops or you have noticed a visible change to their eye appearance, have a chat with your patient to find out if they have had their thyroid checked. The early symptoms are so easy to dismiss as allergies or colds. If your patient already has Grave’s Disease and you notice a visible change, inquire to if they have spoken with their doctors about the situation with their eyes. Many patients are unaware of the link between their eyes and their thyroid and it doesn’t occur to them to even mention it. Lastly, if your patient is a smoker and has Grave’s Disease or GO, encourage them to quit as smoking can make the body resistant to treatment and escalate the disorder.

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