You will need to be followed by an oculoplastic surgeon familiar with Graves. At each visit, pressures should be checked, proptosis (bulging) measurements taken, visual fields done, strabismus measured and color cards done for color vision. At some point, xrays of your orbits will need to be done. The risks include optic neuritis which is potentially blinding and glaucoma from decreased room in the orbits due to bulging muscles. The progression of the eye disease has to stop and remain stable (burn out) for at least 6 months before any reconstructive surgery or strabismus surgery. There is a new drug, Tepezza, that has been shown to be effective. I had zero luck with selenium or diet changes. You need to keep your thyroid levels stable, which is hard to do if you are on methimazole. I chose total thyroidectomy. Should the eye disease threaten sight before burnout, there are options like high dose steroids or orbital radiation. For dry eyes, there is are prescription drops like Restasis and Xiidra (I found this to work really well) as well as unpreserved over the counter lubricating drops. Sleeping with your eyes covered with a mask or plastic wrap helps in severe dryness. The most important thing you can do is find an ophthalmologist, preferably an oculoplastic surgeon, with a lot of experience with Graves. You may need to travel to a teaching hospital or specialized eye center.
Edited Liz1967 (March 20, 2021 15:48:55)