Dysthyroid optic neuropathy (DON) is a serious complication of thyroid eye disease arising in the context of Graves' disease, in which orbital inflammation and congestion compress the blood supply of the optic nerve within the bony orbit.
Compressive optic neuropathy in this setting — often heralded by dyschromatopsia, decreased vision, and/or visual field defects — is considered an ophthalmic emergency requiring immediate treatment. The pathophysiology is inflammation and congestion of the orbital apex, which compresses the blood supply of the optic nerve within its confined bony orbit.
Orbital decompression — a surgical approach to relieve pressure on the optic nerve and its blood supply — forms the core intervention in this scenario, typically performed alongside systemic medical therapy. The complete structured regimen is available via the link below.
DOI: 10.1016/j.ecl.2021.12.004.