Thyroid Eye Disease


What is Thyroid Eye Disease?

In some patients, abnormalities related to thyroid function can manifest with changes in the structures around the eye. While most patients with thyroid abnormalities, such as Graves disease, have no eye involvement, a minority develop signs of thyroid eye disease (TED). Inflammation can cause eye irritation, discomfort, redness and/or swelling of the eyelids and eyes. The eye may become more prominent and appear to be larger, which contributes to a surprised look. In more severe cases, double vision, eye misalignment and even vision loss may occur. 

The specific treatment option for you will depend on the severity of your TED. Often, your surgeon will order imaging studies (CT or MRI) for surgical planning. If you do come for an evaluation, please try to obtain and bring any available imaging studies (CT/MRI) to your visit. Past photos are often helpful to help understand the progression of your condition.

The Treatment :

The treatment options are broad in TED. For the mildest forms, no treatment or symptomatic treatment with medications or lifestyle changes may be all that is recommended. As TED can change many adjacent structures, surgery can be considered to improve the appearance and/or function of the eyelids or structures around the eye. This may include surgeries for the eyelids, eye muscles, or even the surrounding bony anatomy. 

The specific surgery and approach will depend on the specific treatment of interest. Some orbital surgeries can be performed through incisions on the inside of the eyelid, and usually heal without a scar. In some cases, skin incisions are required. In more extensive surgery, removal of bony tissue may be required. Specifics can be discussed on a case by case basis.

Typically, the surgery is performed in an outpatient (non-hospital) setting. Anesthesia may be under either light anesthesia (IV sedation and local medication injected at the surgical site) or general anesthesia (you are asleep for the procedure). Patients are able to go home the same day of the procedure. 

What to Expect After Surgery :

For surgeries requiring general anesthesia, you may go home with a patch over the eye for the first few days up to 1 week. Bruising, swelling is typical after eyelid surgery and peaks in the first post-operative week. We recommend remaining home to recover for approximately one week. Thereafter, most patients can comfortably return to work. During the recovery period, heavy exertion is avoided.