Ocular involvement in Graves’ Disease

Amongst all the medical specialties, ophthalmology leads the field in terms of technical and technological innovation. This doesn’t just apply to lasers on the cornea and robots in the retina: it applies to orbital surgery too.

Graves’ Disease is an autoimmune disease that affects the thyroid, and is the most common cause of hypothyroidism (an underactive thyroid). Most people with Graves’ Disease go on to have eye problems, particularly exophthalmos (eye bulging). What causes this is endocrine orbitopathy: the eye muscles thicken so much that there’s no longer enough space in the eye socket to accommodate the eye. The eyeball starts to be pushed forward and starts to bulge outwards – which can have increasingly dire consequences for the eye if left untreated. But it causes another problem: patients can become disturbed and distressed by this change in their self-image.

Endocrine Orbitopathy

Endocrine orbitopathy (EO) usually occurs in both eyes at the same time, but its time of onset does not necessarily coincide with the start of thyroid disease. Sometimes endocrine orbitopathy occurs at the same time, sometimes it is the first sign of Graves’ disease, and sometimes it occurs only after some time after other thyroid dysfunction symptoms manifest. In about 10% of cases, endocrine orbitopathy even occurs without any sign of thyroid disorders.

Symptoms

The symptoms of EO can be extremely different. People with EO regularly report symptoms of dry eye (tears, burning, photosensitivity, blurred vision, foreign body sensation, pressure behind the eye). In addition, other signs of inflammation may occur (swollen eyelids, swollen conjunctiva, redness of the eyes). But one of the most common signs is exophthalmos, which usually presents with upper eyelid retraction and a low blink rate. As the disease progresses, diplopia (seeing double) can start to occur.

The endocrine orbitopathy often extends over months to years and typically follows a course of increasingly progressive symptoms (known as the “active phase”) which is eventually followed by a phase of remission (burnt out/inactive phase).

Effective medical therapy to treat EO is essentially limited to oral steroid use – but the side effects of steroid use – particularly when used for extended periods – are often unpleasant. Unfortunately, if a person with EO stops taking steroid therapy, the disease recommences. The alternative to this is ocular surgery to improve the ocular eye’s position in the eye socket. This is called orbital decompression surgery. This can only be done when the endocrine orbitopathy has come to rest. We will do such an operation only after consultation with the treating endocrinological team.

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Augeninstitut ELZA
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Squitieri Elias
Squitieri Elias
12:43 08 Sep 21
Die Behandlungen waren bei mir erfolgreich, alle waren sehr nett und haben mein Leben vereinfacht.Danke
Eliane Bossart
Eliane Bossart
13:01 05 Sep 21
Vor einem Jahr war ich einer ganz verzweifelten Situation und total im Stich gelassen. Meine Augen wurden aufgrund... eines ausgeprägten Kerakotonus immer schlechter, ich hatte Angst und war alleine mit meinen Problemen. Zudem vertrug ich die Kontaktlinsen nur noch ganz schlecht und hatte jeden Tag Schmerzen.Professor Hafezi hat mir mit zwei Operationen wieder das auf Grund der Situation mögliche an Lebensqualität zurückgebracht. Es war ein starpaziöses Jahr mit vielen Entbehrungen aber es hat sich gelohnt! Herzlichen Dank fuer die Unterstützung.read more
Gabriela Meyer
Gabriela Meyer
18:32 22 Aug 21
Ich wurde von meiner Optikerin auf Prof. Dr. Dr. Hafezi aufmerksam gemacht. Es war mir vorher nicht bewusst, dass meine... Augenkrankheit (Keratokonus) operativ mittels Cross Linking behandelt und so gestoppt werden kann. Die Beratung und Behandlung war sehr kompetent und ich fühlte mich jederzeit wohl. Die Operation verlief gut und das Ergebnis ist einwandfrei.read more
Naomi
Naomi
11:38 11 Aug 21
Ich bin sehr glücklich, dass ich das Elza Institute gefunden habe. Ich wurde von anderen Augenärzten abgewiesen, da... meine Augen zu kompliziert/schwierig zu behandeln waren. Prof. Dr. Dr. Hafezi konnte mir jedoch helfen und ich bin sehr glücklich und zufrieden mit dem Resultat. Vielen Dank!read more
Till B
Till B
08:30 19 Jul 21
Ich habe eine überaus kompetente Beratung und Behandlung erlebt. Die gesamte Betreuung war sehr freundlich und... professionell. Herzlichen Dank!read more
Thomas S.
Thomas S.
09:37 07 Jul 21
My left eye had to be operated on because of a cataract. As I had an Artiflex lens implanted a few years ago, it had to... be removed first before a modern lens could be implanted to correct the cataract. Prof. Hafezi treated me in an very competent and friendly manner. I am very happy with the result.read more
Selma A. Rahim
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
Steven H.A
Steven H.A
16:13 11 Jan 21
Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
Online Commande
Online Commande
09:19 05 Dec 20
Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
Elena Churilova
Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
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Augeninstitut ELZA
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Based on 90 reviews
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