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.

Sintomas

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
4.8
Como base em 109 críticas
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mike
mike
09:02 04 Jan 23
Overall as a 50 year old, who wanted to continue to avoid wearing glasses and/or contact lenses, my goal was 100%... achieved with ELZA and Dr. Hafezi. I greatly appreciated the overall approach by Dr. Hafezi and his friendly and competent team in reviewing my vision at the start and following a comprehensive eye exam- the explanations of my options. For me I chose PRK in one eye for a monovision solution to correct short sightedness which was becoming more prevalent in night driving and sports such as skiing and cycling. PRK heals slowly but the outcome is worth the wait- and the cost- you use your eyes every waking moment- and for me I cannot see any reason not to pursue better vision with the ELZA team! A great quality of life enhancement!ler mais
Zuzana Fecko
Zuzana Fecko
21:48 31 Oct 22
Thank you so much, Dr. Torres and prof. Hafezi. 26 years I was only “dreaming” about the eye surgery due to possible... complications. I was worried ..Thank you for encouraging me to make a decision and thank you for your professionalism, explanations and great work!I wish you all the best, lots of success and only happy patients!ler mais
Serena Fazio
Serena Fazio
11:15 06 Mar 22
I have been to the ELZA clinic to have surgery for my miopy, as my eyes were rejecting the contacts and I was tired of... wearing glasses. From the first preliminary visit, to the actual surgery and post-surgery care Dr. Hafezi and all his collaborators have been extremely professional, considerate and helpful. All the steps of the (very short!) surgery were thoroughly explained to me in order to be as calm as possible, together with the medication plan and precautions to be aware of so that my eyes could heal in the best way possible. By following their exact instructions, the healing process has been very successful and smooth, and after about one week I was able to see perfectly. I absolutely recommend this team and their expertise!ler mais
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
Thunder Shiviah
14:05 23 Nov 21
After some research on local options I decided to go with ELZA since it stood out as the best. The operation and the... post-operation recovery went extremely smooth (something I was worried about with PRK). Now my vision is much better than I had hoped and I have no side effects such as dry eye or night vision problems. Thank you!ler mais
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.ler mais
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 youler mais
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.ler mais
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!ler mais
Michele Aggiato
Michele Aggiato
18:17 10 Jan 20
The day I had Prof Hafezi checking my keratoconus I knew I was finally in the right place after years of searching for... a good ophthalmologist. Prof Hafezi recommended a surgery due to a drastic degeneration of my cornea. The surgery was performed by himself with the assistance of Dr Rodriguez, one more collaborator of Prof Hafezi’s team who got my full trust.ler mais
Ashley Faulkes
Ashley Faulkes
15:30 21 Mar 16
Professor Hafezi and the team at the ELZA Institute have done an amazing job of creating a first class eye clinic, with... cutting edge technology and support. I went there for a dry eye issue and other issues with my prescription, and they were easily able to help me and put me on the road to better vision! High recommend them to anyone in the Zurich/Aargau area.ler mais
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Augeninstitut ELZA
4.8
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