This book is intended as an educational resource and guide for patients with Graves' ophthalmopathy (GO), an inflammatory eye disorder that often precedes, accompanies, or follows autoimmune thyroid disease. Although the thyroid and eye conditions usually occur simultaneously, GO may occur as much as ten years before and 20 years after the initial thyroid disorder emerges.

The most common types of thyroid disease occur when the thyroid gland fails to secrete adequate thyroid hormone, causing a condition known as hypothyroidism; alternately, the thyroid gland may secrete excess thyroid hormone, causing a condition known as hyperthyroidism. Graves' disease is an autoimmune hyperthyroid disorder and the most common cause of hyperthyroidism.

GO primarily occurs in patients with Graves' disease (80 percent of all cases); and in a smaller number of individuals with Hashimoto's thyroiditis (HT), an autoimmune hypothyroid disorder. GO may also occur in people who have no signs of thyroid disease (these people are said to have euthyroid Graves' disease). Approximately ten percent of all GO occurs in people with euthyroid Graves' disease, and another ten percent occurs in people with HT.

Thyroid associated eye disorders are known by a number of different names, including Graves' ophthalmopathy (GO); thyroid eye disease (TED); thyroid associated ophthalmopathy (TAO); dysthyroid orbitopathy; thyroid ophthalmopathy; immune exophthalmos; and Graves' eye disease. In this book, the condition of thyroid related eye disease will be referred to simply as GO.

Both autoimmune thyroid disease (AITD) and GO, like most autoimmune disorders, result from a combination of genetic and environmental factors. That is, individuals with a certain combination of genes develop AITD and GO when they're exposed to certain environmental triggers, including stress, infectious agents, iodine, interferon and interleukin medications and sex steroids. Thyroid autoantibodies that contribute to the development of AITD also play a significant role in the development of GO, particularly the congestive form of GO. A complex disease, which is unique in each individual, GO may affect the eyelids, the orbital muscles, the orbital connective tissue and the orbital fat deposits.

My goal in writing Thyroid Eye Disease: Understanding Graves Ophthamopathy is to educate, support and empower patients with GO. Intended as an overall guide, this book describes all facets of GO—including the development, signs, symptoms, diagnostic tests, risk factors, conventional and complementary treatment options, complications, and psychosocial manifestations of GO.

In any disease state, but particularly in diseases with an autoimmune origin, knowledge is empowering. Armed with an understanding of the endocrine, environmental, genetic and immunological factors that lead to GO, you can better understand how this disease develops and realize the importance of your own role in the healing process.