Graves Orbitopathy (GO)

This condition can cause blindness by one of two mechanisms

  1. corneal exposure leading to corneal ulcer
  2. optic nerve compression

Graves Orbitopathy (GO), also known as thyroid eye disease, can also cause significant and lasting problems with diplopia and cosmetic appearance.

It is characterised by swelling of the orbital tissues including the extra-ocular muscles.

It may present as redness, grittiness, puffy eyelids and variable diplopia (eg in upgaze). As GP’s we can potentially miss the diagnosis and treat ‘conjunctivitis’ for weeks before the diagnosis is apparent.

There are 2 key messages for GP’s, in addition to recognising this condition.

  1. It is smoking related. Every effort should be made to encourage and support patients to stop smoking
  2. It is exacerbated by poor control of thyroid function: Involve an endocrinologist early to achieve and maintain euthyroid status.

Safety netting: Advise any patient to seek urgent attention if they develop pain or reduced vision.

  • What 2 mechanisms can lead to blindness in GO?
  • What are the two most important factors in controlling GO?
  • Can you describe some of the eye symptoms and signs of GO?
  • Which demographic is most at risk?

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