In mild cases, cool compresses, sunglasses and artificial tears provide relief. People with Graves' eye disease often are advised to sleep with their heads elevated to reduce eyelid swelling. If double vision is a continuing problem, glasses containing prisms may be prescribed or surgery on the muscles may be advised.
A selenium supplement may help reduce swelling and decrease mild symptoms.
A corticosteroid drug, taken by mouth or intravenously, is the main therapy for Graves' eye disease. Oral prednisone is used most often when eye bulging and swelling continue to get worse. High dose prednisone or an intravenous corticosteroid is used if there is compression of the optic nerve. This is the most serious complication of Graves' eye disease.
In more stubborn cases, external radiation treatment of the eye socket may be considered to ease swelling. However, studies on the long term benefits of external radiation are not conclusive. Also radiation near the eye may damage the retina.
The most common surgery for Graves' eye disease is eyelid surgery to reposition the eyelid. In addition, surgery on the eye muscles can be done to realign the eyes. These procedures are performed by an eye specialist called an ophthalmologist.
When sight is threatened, a type of surgery called orbital decompression is done. In this procedure, a bone between the eye socket (orbit) and sinuses is removed to allow more space for the swollen tissues. This more complicated operation requires a medical center with expertise in this area.
It is important that thyroid blood levels be maintained in the normal range. After treatment of an overactive thyroid, there is a substantial risk of becoming hypothyroid (an under active gland). Thyroid replacement is essential to help keep Graves' eye disease from getting worse.