Elaine Moore

With sophisticated imaging tests, nearly all Graves' Disease patients show evidence of ocular changes. However, clinically significant Graves' Ophthalmopathy (GO) only occurs in 10% to 25% of GD patients. Of these, only 5% have severe GO. Read about the pathology, symptoms, signs, development & treatment of GO in my Grave Disease book's 30 page chapter on GO and also in my Thyroid Eye Disease book, released in 2003.

Graves' Ophthalmopathy generally develops within 18 months of thyroid symptoms, although it may occur before the thyroid disease emerges. It may also occur in the absence of thyroid symptoms in a condition called euthyroid Graves' disease.

GO runs an independent course, occurring before hyperthyroidism in 20% of patients, simultaneously in 40%, and after symptoms of hyperthyroidism develop in 40% of patients. Smokers are 7.7 times more likely to develop GO than nonsmokers. There are 2 variations of GO, an autoimmune induced congestive infiltration and a spastic or staring disorder caused by excess thyroid hormone. Eye symptoms are classified by a system called NOSPECS with class 0 = no symptoms and class 6 = sight loss due to optic nerve compression.

A short course of steroids often helps symptoms of GO, although when used at higher doses, symptoms may return in full force when the steroids are discontinued. Natural methods used to slow down the immune system, including dietary changes, can also help reduce symptoms.