Graves Ophthalmopathy Exophthalmos

Grave’s Disease

Goiter IllustrationGrave’s disease is an autoimmune disorder that leads to over activity of the thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks healthy tissue. Diffuse toxic goiter: Graves’ disease is the most common cause of hyperthyroidism (over activity of the thyroid gland), with generalized diffuse over activity (“toxicity”) of the entire thyroid gland which becomes enlarged into a goiter.

When the body makes too much thyroid hormone, the condition is called hyperthyroidism. (An underactive thyroid leads to hypothyroidism.)

Graves’ disease is the most common cause of hyperthyroidism. It is due to an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone. Graves’ disease is most common in women over age 20, but the disorder can occur at any age and can affect men as well.

Younger patients may have these symptoms:

  • Anxiety
  • Breast enlargement in men (possible)
  • Difficulty concentrating
  • Double vision
  • Eyeballs that bulge (exophthalmos)
  • Eye irritation and tearing
  • Fatigue
  • Frequent bowel movements
  • Goiter (possible)
  • Heat intolerance
  • Increased appetite
  • Increased sweating
  • Irregular menstrual periods in women
  • Muscle weakness of the hips and shoulders
  • Moodiness
  • Nervousness
  • Rapid or irregular heartbeat (palpitations or arrhythmia)
  • Restlessness and difficulty sleeping
  • Shortness of breath with activity
  • Tremor
  • Weight loss (weight gain in some cases)

Older patients may have these symptoms:

  • Rapid or irregular heartbeat
  • Chest pain
  • Memory loss
  • Weakness and fatigue

Graves’ Ophthalmopathy
Graves OphthalmopathyAbout 30 percent of people with Graves’ disease show some signs and symptoms of Graves Ophthalmopathy. In Graves’ Ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes. The resulting signs and symptoms may include:

  • Bulging eyes (exophthalmos)
  • Gritty sensation in the eyes
  • Pressure or pain in the eyes
  • Puffy or retracted eyelids
  • Reddened or inflamed eyes
  • Light sensitivity
  • Double vision
  • Vision loss

Graves’ Ophthalmopathy is also known as thyroid eye disease (TED), dysthyroid/thyroid-associated orbitopathy (TAO) or Graves’ orbitopath.

Graves’ Dermopathy (also known as Pretibial Myxedema)
Pretibial Myxedema or Graves' DermopathyAn uncommon manifestation of Graves’ disease, called Graves’ Dermopathy is the reddening and thickening of the skin, most often on the shins or the tops of the feet.

Call your health care provider if you have symptoms of Graves disease. Also call if your eye problems or other symptoms get worse or do not improve with treatment.

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of hyperthyroidism with:

  • Decrease in consciousness
  • Fever
  • Rapid, irregular heartbeat

Alternative Names: Diffuse thyrotoxic goiter

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