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Exophthalmos is a protrusion of the eyeball from the eye socket that can affect one or both eyes. The condition, commonly associated with abnormal thyroid levels found in Graves’ disease, can become quite serious, causing lasting visual impairment. Approximately one-third of patients with Graves’ disease experience thyroid eye disease, and this population frequently has exophthalmos.

There are many treatment options for the condition, including orbital radiotherapy (RT) that delivers low doses of radiation to the eyes to help reduce swelling. Orbital radiotherapy may be utilized initially as the primary treatment, or it may be considered if the condition worsens. It is often combined with corticosteroids, especially if steroids alone have been ineffective.

About¬†Graves’ Disease

  • Graves’ disease is the leading cause of hyperthyroidism, which can cause complications with metabolism, breathing, nervous system functions, and emotional and cognitive functions.
  • Graves’ disease is much more common in women than in men.
  • About 2-3% of people will be affected by Graves’ disease.
  • Graves’ disease is most commonly diagnosed in middle age.

Radiation Therapy Proves to be Effective Treatment Option

A number of clinical studies demonstrate that orbital radiotherapy is effective in treating eye symptoms caused by Graves’ disease:

  • A study of eight randomized trials with a total of 439 patients showed the overall response to treatment was better for patients treated with radiation therapy combined with glucocorticoids compared to patients treated only with glucocorticoids. The study concluded that radiation therapy can improve many ocular symptoms and “should be offered as a valid therapeutic option to patients with moderate to severe ophthalmopathy.”
  • A study of 91 patients examined radiation therapy as an initial treatment for Graves’ ophthalmopathy and assessed the need for post-radiation salvage bony decompressive surgery. Following radiation therapy, 92.3% of patients saw stabilized or improved symptoms, with only 21% of patients needing surgery.
  • A study examining the medical records of 17 patients who received radiation therapy for Graves’ ophthalmopathy showed 60-65% of patients responded favorably to radiation therapy alone, and 87-97% responded favorably when radiation therapy was combined with steroids. The study concluded that “RT [radiation therapy] is an effective treatment option in GO [Graves’ ophthalmopathy] even in patients who failed previous treatment with steroids or surgical decompression.”

Our Expertise

Our highly skilled radiation oncologists have extensive experience in treating patients with exophthalmos. Our leading-edge radiation planning and treatment technologies, coupled with the deep expertise of our treatment team, ensure patients receive the safest, most effective treatment possible. We work closely with our referring physicians, collaborating and communicating with them throughout the entire treatment process so they can closely follow their patient’s progress. We are committed to providing our mutual patients the best possible care. To learn more about how radiotherapy can help patients with Graves’ disease, please contact our radiation care team today.

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