Graves' Ophthalmopathy

A 40-year-old woman in whom Graves' disease was recently diagnosed comes for a follow-up visit. She has been taking methimazole, at a dose of 10 mg per day, and is now euthyroid, but for the past 3 months, she has had bothersome eye symptoms, including redness, tearing, grittiness, photophobia, diplopia at the extremes of gaze, and ocular pain associated with eye movements. She smokes 10 cigarettes per day. How should Graves' ophthalmopathy be managed? A 40-year-old woman in whom Graves' disease was recently diagnosed comes for a follow-up visit. For the past 3 months, she has had bothersome eye symptoms, including redness, tearing, grittiness, photophobia, diplopia at the extremes of gaze, and ocular pain. How should Graves' ophthalmopathy be managed? Foreword This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations. Stage A 40-year-old woman who recently received a diagnosis of Graves' disease comes for a follow-up visit. She has been taking methimazole, at a dose of 10 mg daily, and is now euthyroid, but for the past 3 months, she has had bothersome eye symptoms, including redness, tearing, grittiness, photophobia, diplopia at the extremes of gaze, and ocular pain with eye movements. She smokes 10 cigarettes per day. Examination reveals exophthalmos, swelling of periorbital tissues, and limitation of eye movements. How should Graves' ophthalmopathy be managed? The Clinical Problem Graves' disease is often characterized by ocular manifestations of autoimmune origin, . . .