Graves' disease is a disorder of the immune system that affects thyroid, skin and eye in the body. Though it may occur in any age in both the sexes, it is generally more common in females in the age group 20 to 60 years.
Normally the immune system in the body makes antibodies, which have a role in protecting the body from viruses, bacteria and other foreign substances. In graves' disease the immune system mistakenly attacks the thyroid gland, eyes and skin of the lower limb, causing the symptoms.
As explained above, this disease affects thyroid gland, skin and eyes. Thyroid is a gland located in the neck region and is responsible for secreting a hormone that controls the metabolism and growth of the body. In graves' disease the secretion of thyroid gland is generally increased by the antibodies, leading to a condition known as hyperthyroidism. The symptoms of this condition are:
Some people with Graves' disease suffer from an irritating skin condition. Skin over the shins appears red and swollen. The top of the feet also may be affected in this way.
Graves' disease also affects the eye and leads to a condition known as Graves' ophthalmopathy. Eye symptoms and hyperthyroidism symptoms usually appear within 18 months of each other. It generally involves both eyes, though even one eye may be involved.
The antibodies act on the tissues behind the eyeball. These get inflamed and attract and hold water. This leads to swelling of tissues and muscles, causing the eyeball to protrude forwards and also leads to some decrease in mobility of the eyeball. The symptoms of this condition therefore are:
Besides causing inconvenience in form of decreased movement and double vision, graves' ophthalmopathy may also lead to serious vision threatening complications. These are:
First of all the thyroid status is determined and is treated accordingly, based on whether the thyroid hormone levels are high or normal or even low. The treatment for the eye condition depends upon the severity of the disease as well as the stage of the disease. The patient may need one or a combination of the following treatment options:
Depending upon the condition of the eyes, the ophthalmologist may advise a surgery. The following surgeries are done for this condition:
If the eye requires all these three surgeries, the sequence is orbital decompression, eye muscle surgery and then eyelid surgery.