How is Thyroid-Associated Ophthalmopathy Treated?

Treatment of thyroid-associated ophthalmopathy includes systemic therapy and ocular therapy, as outlined below.

1. Systemic Therapy
   The main goal is to treat thyroid dysfunction, usually managed under the guidance of an endocrinologist.
2. Ocular Therapy Pharmacological treatmentIn the early stage of the disease, when inflammatory reactions are prominent, glucocorticoids are used, which can be administered intravenously, orally, or via retro-orbital injection.For patients with contraindications, other immunosuppressive agents may be used.In cases of incomplete eyelid closure with severe corneal ulceration, a moisture chamber goggle should be used to protect the cornea; tarsorrhaphy may be performed if necessary.
   Radiation therapyRadiation therapy may be used in patients who do not respond to pharmacological treatment or have contraindications to medications.
   Surgical treatmentSurgery is indicated for: Stable eyelid and extraocular muscle disease;
   Elevated intraocular pressure unresponsive to medical treatment;
   Occurrence of optic neuropathy or severe corneal lesions;
   Patients with cosmetic concerns.

Different procedures are chosen based on disease severity. The general sequence of surgery is:orbital decompression → extraocular muscle correction → eyelid surgery.