Medical and Surgical Options in Thyroid Eye Disease

  • Peter J. Dolman


Thyroid eye disease (TED) is an immune-mediated disorder causing inflammation and expansion of orbital fat and muscle. The resulting spectrum of ocular and orbital changes may cause significant morbidity and is graded as disease severity. The disease follows a biphasic course with an active or progressive phase followed by a quiescent or stable phase. Appropriate management depends on an accurate and reproducible evaluation system documenting both disease severity and activity: one available method is the VISA classification. Options for managing TED include various medical therapies or radiotherapy—both of which are typically employed during the early progressive stage of the disease—and surgery, which is most commonly used during the quiescent stage, with the exception of surgery in the active phase when vision is threatened due to optic nerve compression or corneal breakdown. The VISA classification provides a logical model for choosing management based on its measurements.


Graves’ orbitopathy Thyroid eye disease Thyroid-associated orbitopathy Dysthyroid optic neuropathy Clinical activity score VISA classification Corticosteroids Rituximab Selenium Radiotherapy Orbital decompression Strabismus repair 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Peter J. Dolman
    • 1
  1. 1.Oculoplastics and Orbit, Department of Ophthalmology and Visual SciencesUniversity of British Columbia, Eye Care CenterVancouverCanada

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