Thyroid Eye Disease
Hyperthyroidism (Grave’s disease) is a condition in which there is overproduction of thyroid hormones. Many patients start experiencing eye problems as soon as their thyroid gland becomes overactive. For some, the eye changes may develop before hyperthyroidism is detected, while others may not develop symptoms until months or years later. Both eyes are usually affected. However, they may not be affected to the same degree.
Common symptoms are pressure around the eyes, ocular irritation and tearing. Overexposure during the day and difficulty closing the eyes at night can lead to dryness or injury to the cornea.
Inflammation of the eye muscles may result in restricted eye movement causing double vision. If the muscles become too swollen, the enlarged muscles can compress the optic nerve, resulting in progressive visual loss.
After several months and up to two years, the active inflammation subsides. Many patients will be left with some degree of protrusion, lid retraction, or double vision that may require additional treatment.
For many people, the discomfort from thyroid eye disease can be treated with topical lubricants, wrap-around tinted glasses, sleeping with eye shields and with the head elevated.
When there is active inflammation that threatens vision, oral cortisone or other anti-inflammatory medications may be needed and it can take up to two years to reduce the swelling. Radiation is sometimes used to treat active inflammation as well. If the swelling behind the eye is severe enough, surgery may be necessary to decompress the orbit.
The function and appearance of the eyes can usually be improved by reconstructive eyelid or orbital surgery. Surgical treatment is generally delayed until the active inflammation subsides. The particular surgical technique used will depend on the type and severity of the eye problems.
Orbital decompression (removing part of the bony orbit and fat behind the eye to relieve pressure within the eye socket) can prevent damage to the optic nerve, and allow the eyes to move back into a more normal position in the eye socket.
Misalignment of the eyes and double vision can be improved with eye muscle surgery to reposition the enlarged muscles that control eye movement.
Eyelid surgery to adjust the position of retracted lids can improve eyelid closure and restore eyelid function. Removal of excessive fat from the eyelids can also improve their appearance.
Your surgery will be performed by Dr. Maleki, a board certified ophthalmologist that also has had extensive training in ophthalmic plastic and reconstructive surgery.