Assessment and management of the patient with Graves' ophthalmopathy

The appropriate management of a patient with Graves' ophthalmopathy (GO) can be determined only following a careful assessment of the signs and symptoms of the disease. A detailed examination and discussion allows the clinician to determine which components of the disease are most troublesome to that particular patient. The advantages and disadvantages of the various treatment options for each disease component can be best understood in light of current concepts of the pathogenesis of GO. This paper will begin with a discussion of the histologic and gross pathologic features of the disease, followed by a brief review of pathogenic mechanisms responsible for their development. The assessment of a patient with GO will be discussed and the modes of therapy available to address each of the signs and symptoms will be reviewed. Readers interested in a more detailed discussion of the management of GO are encouraged to read the excellent recent review by Drs. Burch and Wartofsky.