Treatment of Graves’ Orbitopathy with Sight-Threatening Thyroid Eye Disease and Corneal Breakdown

Sight-threatening thyroid eye disease with corneal breakdown represents an urgent clinical presentation of Graves’ orbitopathy requiring prompt, targeted intervention to preserve vision and ocular surface integrity.

Clinical Scenario

This protocol addresses patients with Graves’ orbitopathy presenting with sight-threatening thyroid eye disease complicated by corneal breakdown — a high-acuity subset in whom the risk of irreversible visual loss is immediate.

Treatment Approach (Partial Overview)

Management centres on protecting the ocular surface through a combination of local measures and, where active underlying disease is present, parallel systemic intervention. Surgical approaches to the eyelids play a central role alongside supportive topical therapy.

Full regimen, sequencing, and criteria available via the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

Patients with DON and/or corneal breakdown and/or globe subluxation (Fig. 2f)
Lubricants and topical antibiotics
Bandaging
Tarsorrhaphy
If there is coexistent active disease, then medical treatment as for moderate-to-severe disease is indicated in parallel with surgical treatment.

doi: 10.1089/thy.2022.0251

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