What is Thyroid Eye Disease?
When thyroid-related immune orbitopathy occurs, the extraocular muscles (muscles that move the eyes) and the orbital fat (fat behind the eye) swell and become inflamed. The swelling of these areas can cause the eyes to move forward, resulting in bulging of the eyes and restricted eye movements. In some cases it can cause compression of the optic nerve, resulting in vision loss or crossed eyes.
One of the most common features of thyroid eye disease (also called “Graves’ disease”) is eyelid retraction. This means that the upper, lower or both eyelids can become too open, leading to eye irritation from dryness and difficulty keeping their eyes closed when they sleep. In addition to that, people suffering from eyelid retraction often appear like they are staring or surprised.
Thyroid Eye Disease Treatment Options
The two techniques that Oculoplastic surgeon Dr. Amiya Prasad often uses in thyroid eye treatment are as follows:
Eyelid Retraction Repair Surgery
Eyelid retraction repair surgery can be performed to improve the appearance of the eyes, as well as improve the function of the eyelids. The more retracted the eyelid is, the more complex the procedure typically is. Eyelid surgery is usually done after the inflammatory stage of thyroid eye disease has resolved, which allows Dr. Prasad to perform the surgery in a more predictable manner.
Orbital Decompression Surgery
Orbital decompression surgery reduces fat behind the eye and opens the bony structure around the eye to allow the swollen tissue to move into a space. This allows the eyes to move back to a more normal position and reduce pressure on the optic nerve. Orbital decompression is typically performed in our operating facilities under general anesthesia.
Clinical Case Studies
This 52-year-old African-American female complained of severe swelling around her eyes and difficulty blinking due to the fact that her extra ocular muscles had swollen from thyroid eye disease. Dr. Prasad performed a bony orbital decompression, which allowed her eyes to recede into a more natural position.
This 38-year-old man had complained of the appearance of his left upper eyelid as well as dryness affecting his left eye. Dr. Prasad performed a repair of the left upper eyelid retraction resulting in relief from his thyroid eye disease symptoms as well as an improvement in his appearance.
This 31-year-old mother of two was very unhappy with the appearance of her eyes due to thyroid eye disease. She felt that her right eye, which bulged more, made her look very strange and that she had bags under her eyes, which had gotten worse with the Graves’ disease. Dr. Prasad performed a right upper eyelid retraction repair with temporalis fascia graft and bilateral lower eyelid transconjunctival blepharoplasty. After the surgery she was very happy with the improvement in the symmetry of her eyes and the natural result.
This woman was 43-years old and had Graves’ disease for approximately 2 and a half years. Once the disease resolved and her thyroid was stable, her eyelids remained too open. Dr. Prasad performed bilateral upper eyelid retraction repair to address the bulging from her thyroid eye disease.
Thyroid Eye Disease Surgery by Dr. Amiya Prasad
For years, patients with Graves’ disease were obliged to accept their appearance with no hope of correcting their eyelid problems. In addition, they were often plagued by problems such as dry eye and poor vision. However, today, innovative cosmetic techniques in thyroid eye treatment have revolutionized the eye problems related to this disease. As a specialist in thyroid eye disease, Dr. Prasad has successfully restored vision and improved the appearance of many people through thyroid eye surgery.
Before making a decision, please consider having a personal evaluation with New York eyelid surgery specialist and Oculoplastic surgeon Dr. Amiya Prasad to determine what is the most appropriate procedure(s) for your specific case.