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Thyroid Eye Disease Newport Beach

What to expect with Graves’ eye disease or thyroid eye disease

What is Graves’ disease?

Graves’ disease is a disorder of the immune system in which it begins to attack the body’s own tissues. Generally called an “auto-immune disease”, in Graves’ disease, the immune system can attack the thyroid gland causing an overproduction of thyroid hormone.

What is Thyroid Eye Disease?

In certain people with Graves’ disease, the immune system can also attack the eyes. The result is inflammation and swelling, causing:

  • Puffiness around the eyes
  • Bulging of the eyes
  • Dry eye and irritation

The muscles that move the eye are especially sensitive to the immune attack. Changes to the muscles include:

  • The eye is pushed forward in its socket causing a “staring” appearance
  • A change to the normal movements of the muscles, resulting in double vision

Progressive swelling may cause:

  • Increased pressure inside the eye socket
  • Pressure-pain or deep headache, which worsens with eye movements
  • Rarely, pressure on the optic nerve can lead to decreased vision

Is Graves’ eye disease the same as thyroid eye disease?

Yes. You may hear different terms for this disease. Graves’ eye disease, Graves’ ophthalmopathy, thyroid eye disease, and thyroid-associated ophthalmopathy are used to describe this set of eye complications.

I have Graves’ eye disease, What can I expect?

The primary or active phase of the disease presents first. It is driven by the inflammation caused by your own immune system as described above. It usually lasts from six months to two years. Treatment during this phase is almost always medical, and aims to relieve the eye symptoms. Once the inflammation and other symptoms have subsided, you enter the stable phase where some of the changes created during the onset of the disease may now remain. Surgery can now be used to improve some of the medical and cosmetic issues created.

Common Questions:

How do I treat my dry or burning eyes during thyroid eye disease?

There are several reasons that your eyes struggle to remain lubricated during the active phase and even into the stable phase.

  • Over-the-counter lubricant drops (or artificial tears) offer significant relief.
  • More viscous tears or ointments provide better long lasting coverage.

Is there anything I can do to improve my cosmetic appearance and decrease swelling during Graves’ eye disease?

You may experience prominent swelling during Graves’ eye disease. You may notice bags under the eyes, and increased bulging of the eyes and eyebrows. Anything that increases the fluid in the body can add to the swelling. Some helpful behaviors include:

  • Reducing salt in your diet to decrease fluid retention.
  • Sleeping with your head inclined (elevated above the level of your heart), allowing fluid to settle out of your face.

Is smoking related to thyroid eye disease?

Yes! In several recent studies cigarette smoking has been shown to worsen the disease. If you are a smoker, one of the most important things you can do to help your disease is tostop smoking. Also, Dr. Joseph recommends avoiding secondhand smoke.

The stable phase of thyroid eye disease

What are my surgical options for thyroid eye disease?

Once the disease has stabilized, there are several surgical options that may be needed to correct the bulging appearance of your eyes, minimize double vision, bring the eyelids into the correct position, and address the cosmetic changes caused by Graves’ eye disease.

First stage: minimally invasive orbital decompression surgery
Orbital decompression surgery is designed to remove bone and/or fat from behind the eye, allowing the eye to move back into its socket.

Second stage: eye muscle surgery
In eye muscle surgery, the surgeon repositions the muscles, bringing the eyes into alignment.

Third stage: eyelid repositioning surgery
Often in Graves’ eye disease, the eyelids open too widely. Eyelid repositioning surgery is carried out under local anesthesia on an outpatient basis. The surgeon releases eyelid muscles or tendons that have become tight, allowing the eyelid to return to a more natural position. Sometimes, particularly in the lower eyelid, tissue is added to reinforce the newly relaxed tissues.

Fourth stage: surgery and sculpting to correct the effects of Graves’ eye disease
After these corrective surgeries have been completed, you may discover that Graves’ eye disease has left its mark. Loss of elasticity and puffiness are now permanent features, and the tissues around the eye appear to have aged dramatically.

Dr. Joseph will tailor an aesthetic approach specific to your needs to help reverse these effects.

How can I contact Dr. Jeffrey Joseph, M.D.?

Click here to contact Dr. Joseph’s Newport Beach office and schedule your consultation.


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180 Newport Center Drive, Suite 158, Newport Beach, CA 92660



  • Newport Beach
    180 Newport Center Drive,
    Suite 158
  • Newport Beach, CA 92660
    Tel: 949-424-3524
    Fax: 888-317-9590

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