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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
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10 years ago i had hyperthyroidism and was treated with radioactive

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10 years ago i had hyperthyroidism and was treated with radioactive iodine. 3 years ago I started having graves disease in my right eye. I had decompression surgery twice and the inflamtion is still in full swing. I have been recommended to undergo steroidal injections around the eye concurrent with radiation treatment. I would like to know what would be the best clinic nearest D/FW texas to obtain a second opinion can you help? In general is this the best treatment?
Submitted: 4 years ago.
Category: Eye
Expert:  doctoraha replied 4 years ago.

Hi,

 

Thanks for using just answer.

 

I need some information.

 

Are you smoker?

 

Is radioiodine treatment being given to you second time?

 

Regards

Customer: replied 4 years ago.

Casual Smoker. maybe 2 packs this year nothing since February. No I have not had a second treatment of radioiodine. I have had several tratments of Prednesone over the past two years and this work for a short while.

 

Expert:  doctoraha replied 4 years ago.

sorry for the inconvenience.

 

I am sending your question to eye category so that you get a better suggestion.

 

Regards

Customer: replied 4 years ago.
thank you
Expert:  doctoraha replied 4 years ago.
You are welcome
Expert:  Dr. James replied 4 years ago.
Hello,

I am an ophthalmologist on JustAnswer.

When did the inflammation in the right eye start?
Have you lost vision in that eye?
Where have you been going for treatment thus far?
Customer: replied 4 years ago.

Started March 2007. Biopsied Nov 2008 = negative for cancer. Decompression through nasal area & Biopsy (also Negative) April 2009. Treatments of prednesone off an on as inflamation occurred. 2nd decompress on floor of orbit march 2010. Inflamation has not stopped and irritation continues. now recommended for steroidal shots and radiation. I am very concerned about the effect of this radiation treatment.

 

Test last week revealed slight loss of peripheral vision in right eye - the inflamed eye.

 

Treatment is with a local opthalmic/plastic surgeon in Dallas

Expert:  Dr. James replied 4 years ago.
Thank you for the reply.

Treatment of orbital disease due to graves ophthalmopathy is done by oculoplastic surgeons. You can use the link below to find other specialists in the Dallas area for a second opinion.

http://www.asoprs.org/custom/directory/?pageid=3657&showTitle=1


You may also consider going to UT Southwestern. They are the only academic medical center in the area.

http://www8.utsouthwestern.edu/utsw/cda/dept28050/files/55847.html


It appears you have a particular resistant form of Graves' ophthalmopathy. Most patients will have an active phase of inflammation which last about a year or so. During this time, corticosteroid treatment and radiation can be helpful to reduce the orbital inflammation.

Since the inflammation is still active, then consideration of steroids and radiation should be considered still, even 3 years after the start of the inflammation. There are newer medicines used to suppress the immune system such as TNF inhibitor's, but their effectiveness is still uncertain. Corticosteroid, radiation, and surgical decompression are still the standard treatment.

Please remember to press the accept button so I can receive credit for assisting you.
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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