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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.