The ocular manifestations of disease in the thyroid gland are quite prevalent. They are most commonly associated with an autoimmune disease that affects the thyroid gland and the tissues around the eye, called Graves’ disease. Graves’ disease affects middle-aged women more frequently, although men are also affected.
Thyroid eye disease (TED) may cause eye problems during the active stage of the disease, or it may cause sequelae due to scar formations that become chronic. These scar formations alter the shape and appearance of the eyes.
How does thyroid eye disease cause eye problems?
The ocular symptoms of TED are usually secondary to significant dryness of the eye and inflammation of the tissues surrounding it. People with TED may experience eyelid retraction, a condition where the eyelids open up abnormally. This causes patients to have a “surprised” or “bulging” look in the eyes and results in exposure of the cornea which, in turn, causes severe dryness of the eye, redness and tearing.
An eye specialist or oculoplastic surgeon must manage these symptoms. The best treatment is the frequent use of preservative-free eye drops and ophthalmic gels. In some cases, your ophthalmologist may also prescribe oral anti-inflammatory medications.
On the other hand, TED may cause issues in the eye due to chronic inflammation and the formation of scar tissue around the eye, especially in the eyelids. In these cases, patients observe severe changes in the appearance of their eyes, namely an almost-constant “scared” expression. It is this expression that most commonly leads patients to consult with an eyelid surgeon. In these cases, reconstructive surgery of the orbit and eyelids is required to recover the normal appearance of the eyes.
How can you treat the sequelae of thyroid eye disease disease?
The sequelae of thyroid eye disease can have a significant impact on a person’s quality of life and psychological well-being. The changes that TED causes in the shape and appearance of the eyes can be so dramatic as to change a patient’s appearance.
The main sequelae resulting from TED is retraction of the upper eyelids. Upper eyelid retraction is approached with an operation that lowers the eyelids, and in doing so, helps recover the normal shape and contour of the eyes. It is an outpatient procedure that has a painless recovery. This operation helps to give the patient confidence as they recover their normal eye shape.
Sometimes the lower eyelids also retract downward, causing the eye to push forward, lending them a surprised look. This sequela requires surgery to rearrange the lower eyelids and move them to a higher, regular position. It is also an outpatient operation; however, the recovery time tends to be a bit slower as there is more bruising and swelling. Nevertheless, the operation can do wonders to recover the patient’s eye shape and contour from before the disease.
Both of the procedures mentioned above are performed to help patients with Graves’ disease recover their usual appearance. They are considered to be reconstructive procedures; however, they have significant aesthetic effects on a patient’s appearance.
Seek an oculoplastic surgeon with experience in thyroid eye disease
If you or a person you know suffers from the sequelae of Thyroid Eye Disease, don’t hesitate to call us. Our eyelid specialist can help you regain confidence with the eyes you had before this condition.