Treatment Options for Thyroid Eye or Graves’ Disease at Ohio State

One of the other conditions that I deal with
on a frequent basis is a condition known as thyroid eye disease or Graves’ eye disease.
It goes by many names – Graves’ orbitopathy, thyroid associated with orbitopathy, but basically
it’s an autoimmune condition where the body amounts an immune response, an immune reaction
to both the thyroid and to the tissues in the eye socket. And this can cause swelling
and expansion of the muscles and the fat inside the eye socket. It can push the eyeball forward
and making make the eyelids retract. It can make it so that the muscles don’t move properly
and cause double vision and, in the worst cases, it can cause so much pressure in the
eye socket that it compromises the blood supply to the optic nerves and it can it can cause
blindness. Most of the time the condition can be treated in its acute phase. It can
be treated medically. Sometimes though, such as in the case where the optic nerve is being
compressed, it does require a surgical intervention and that usually involves what’s called an
orbital decompression where one or more of the walls of the eye socket and sometimes
the fat inside the eye socket are removed in order to create more room inside the eye
socket for those expanded orbital tissues that decreases the pressure in the eye socket,
restores the normal blood flow to the optic nerve and and can restore vision to the patient.
When it comes to the orbital decompression one of the things that I’ve had the opportunity
to utilize technology-wise is a technology called ultrasonic bone aspiration. This is
a technology that’s been around for at least fifteen years or so but I’ve had the opportunity
to use it frequently in the setting of orbital decompression for thyroid related orbitopathy.
And the traditional way to remove bone from the eye socket is to use a a high speed drill
but the ultrasonic bone aspirator does it in a much more gentle fashion and in a way
that poses less risk to the orbital soft tissues and also to tissues behind the eye socket
which can include the lining of the brain. I have had the opportunity to use the ultrasonic
bone aspirator on a number of occasions and that’s also a technology that we have available
here at The Ohio State University Wexner Medical Center.

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