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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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her face..radio active treatment of the muscles behind her eyes

Customer Question

My wife is not improving in respect of hyperactive thyriodism. Steriods are causing as much swelling on her face as did the reaction to the radio active iodine. Another visit to hospital specialist agrees and are now considering radio active treatment of the muscles behind her eyes. Not very happy about this as the radio active iodine may have caused her present problem. She had no apparant outward signs of any condition prior to the treatment only a blood sample for a check showed there could be a problem with thyriod.. We dont seem to be getting much further forward. Here eye sight thank goodness is not affected so far but she has had enormous weight gain on face and on rest of her body.Her eyes have become staring and very watery, and she has periferal double vision Are there drugs which will reduce the steriod effects.At this stage its not thought appropriate to use diuretics.
Look fwd to your comments. Customer
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 3 years ago.
Oops...you hit the accept early. I'm here and can work on your question now.
Expert:  Dr. Rick replied 3 years ago.
The orbital radiation treatment is not the same thing as the radioactive Iodine your wife was given to destroy her overactive thyroid tissue....radiation treatment works well on the orbital issues of Graves disease.
Expert:  Dr. Rick replied 3 years ago.
Yes, there are drugs that can be used to decrease the need for steroids. Many of these compounds are drugs used in the treatment of cancer and are best monitored by a physician knowledgeable in their use, usually an Oncologist. The oncologist would work closely with your endocrinologist and ophthalmologist to monitor your wife's progress.

Concerning her proptosis, watering eyes and diplopia, these issues can be addressed with a staged surgical approach. For right now it is important that she avoid exposure and drying of her cornea with copious use of artificial tears, lubricating ointment and, possibly, taping her eyelids closed when she is sleeping. If needed a temporary tarsorrhaphy (sewing together the edges of her eyelids) can be done to protect her eyes.

Should she start to have visual field loss or vision impairment from compression of her optic nerve due to orbital engorgement or eye muscle enlargement it would be necessary to quickly decompress her orbit, usually by removing some bone. I'm sure your wife's ophthalmologist is watching her closely for this possible complication.

Does this make sense to you? Is there anything else I can tell you?
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 2 years ago.
Dr Rick,
My wife`s condition remains much the same as far as her sight is concerned double vision both eyes with prism in her glasses .Face swelling gone down quite a bit,she has been told any operation to rectify dv and the hyperthryiodism is some way off that is after a long course of steroids, radiation treatment and other drugs. Seeing specialist in Jan 2012
Thanks for your interest
Expert:  Dr. Rick replied 2 years ago.
Thank you for the update. I am glad that she has shown some improvement and that she will see a specialist soon.

Let me know if there is anything else I can do to help in the future.

Have a wonderful Holiday Season. :)

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