T receptor antibodies act like a jammed accelerator, forcing the thyroid to overwork, causing Graves’. But eye disease follows its own path because orbital tissues have a separate immune response, sometimes even after thyroid levels are controlled. My own timeline showed this—my thyroid was managed with antithyroid drugs for years, but the proptosis and diplopia only progressed until I accessed teprotumumab here in Mumbai. This biologic, which targets the IGF-1 receptor pathway, confirms that the eye has its own distinct battlefield, separate from the gland itself.
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