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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10916
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi My Dad was diagnosed with Graves Disease approx 12 years

Resolved Question:

Hi
My Dad was diagnosed with Graves Disease approx 12 years ago and he was treated with Radioactive Iodine which apparently only partially destroyed the gland. Since then he has had ongoing struggles with thyroid eye disease which has damaged his sight and he often presents with symptoms of over active thyroid. He has been told that he is not able to have the gland removed surgically due to is size and position. My question is: If the gland is retreated with radioactive iodine would this settle down these symptoms? Or is there something else he can do? This has become a very difficult problem. Regards Marie
Submitted: 4 years ago.
Category: Eye
Expert:  Dr. Rick replied 4 years ago.

Dr. Rick :

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

Dr. Rick :

Graves orbitopathy is caused by antibodies that actually attack the muscles and tissues around the eyes and are not directly correlated to the state that the thyroid is in. As such, retreating his thyroid gland may not have any effect on the activity of his Graves orbitopathy.

Dr. Rick :

Here is an excellent article that explains this concept in detail:

Dr. Rick :

http://en.wikipedia.org/wiki/Graves%27_ophthalmopathy

Dr. Rick :

Treatment options very depending on the stage of the disease. It can involve orbital surgery to decompress the optic nerve, eyelid surgery to cover the cornea and keep it from drying out, oral steroids to decrease inflammation and sometimes even radiation therapy or chemotherapeutic agents are used.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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Dr. Rick :

I see that you are offline. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)


 

Expert:  Dr. Rick replied 4 years ago.
Let me know if there is anything else you would like to discuss pertaining to this issue.
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Customer: replied 4 years ago.
Hi Dr Rick- my apologies for the late response. From reading the article it would seem that there is not much can be done. Are the chemo theraputic agents beneficial and if so what are these or is it better to consider the surgical options because we admit that the idea of this is quite frightening! It seems a bit drastic! Regards Marie
Expert:  Dr. Rick replied 4 years ago.
Actually, chemotherapy is usually used after all other options have failed.....

Surgery is not always necessary but when it is, say for optic nerve compression or serous corneal exposure, it works well. I know it sounds scary but when needed nothing else works quite as well.

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter. I would also be happy to continue to answer any more questions you have until we have resolved your concern.