Endocrine orbitopathy (Graves disease) is a chronic multisystem autoimmune process that leads to pathological changes in extraocular muscles, orbital adipose and surrounding tissues, with subsequent involvement in the pathological process and orbital structures.

Patients complain of pain in the eyeballs, photophobia, watery eyes, diplopia. There is swollen eyelid and paraorbital tissues, exophthalmos of varying severity; there may be restrictions on the movements of the eyeballs, as well as keratitis and corneal ulcer - a serious complication that poses a threat of vision loss. Impairment of the function of the visual organ significantly impairs the quality of life (for example, makes driving difficult), comunication with other people and reduces self-esteem of patients.

The disease develops gradually, has an acute active and chronic inactive stages. In the acute stage, treatment depends on expressiveness, and above all eye symptoms. With mild exophthalmic manifestations, active observation and 6-month use of selenium preparations are sufficient. But in the malignant course, it is at this stage that there are great risks of visual decline due to compression of the optic nerve by the thickened oculomotor muscles and lagophthalmos with significant survival of the eyeball. Without proper ophthalmic accompaniment, this condition can lead to keratopathy with irreversible consequences.

In the chronic stage, irreversible fibrous changes occur in the tissues of the orbit and oculomotor muscles, and only surgical treatment can improve the situation.
"Stained eyes," which beyond recognition change the appearance of a person and constant double-edging due to strabismus, deprive a person of his/her former lifestyle.

It is worth remembering: if treatment starts early, the more chances the patient has to save vision and return to his/her previous appearance!
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