Thyroid Eye Disease

Do you notice any problem with your eyes? Do your eyes look too big or as if they are protruding? Do they look like they are out of their way, displaced and / or deviated? Do you happen to have blurred or double vision, either while looking straight or in extremes of gaze, repeatedly? Have you ever been told that you have your thyroid hormone levels too low, or too high? In case you have experienced any of these eye problems, then you must know that you might have Graves’s Disease, or the Thyroid Eye Disease.

What is the Thyroid Eye Disease?

The Thyroid Eye Disease, also known as the Thyroid Orbitopathy or Graves’ Disease, is a disease that affects the orbit (bony cavity surrounding the eyes) above or behind the eyes. It leads to a displacement of the eye, in almost any direction. Protrusion of the eyes, called exophthalmos or proptosis is also common. Thyroid Eye Disease or TED is an autoimmune disease, which is noted in patients with too high or too low thyroid hormones. Basically, the immune system attacks the thyroid gland, with the consequences of the high or low thyroid hormone levels. The disease, however can also cause damage to the eye; the immune system can attack not only the thyroid gland, but also the eye socket & the extra-ocular muscles, causing a displacement of the eye, eyelids opened too wide, difficulty in movement of the eyes, a frank squint or double vision.

What is the process of treating Thyroid Eye Disease or Grave’s Ophthalmopathy?

The thyroid eye disease surgery treatment depends on the stage of the disease. There are three stages of the disease: the first stage, or the ascending stage, the second stage, or the descending stage, and the last stage, or the stable stage. Generally, surgeries cannot be done during the first two stages of the disease. Anti-inflammatory oral medications are used in these stages in order to keep the symptoms under control.

In the stable stage, there are no more medications that can help, only some artificial tears or eye lubricating ointment can reduce the dryness and the irritation of the eyes. The stable stage is deemed to have been reached, when redness of the eyes reduces and the level of the thyroid hormones themselves stabilize over a period of 6 months to a year. Surgery has to be done in this last stage, and the surgery depends on the kind of problem you have. A consultation with oculoplastic surgery & orbital surgery expert Dr. Debraj Shome can give you all the information you need.

Graves’ disease surgery, however has stages, depending on the problems which have been caused. If the immune system has caused all three problems to the eye: double vision, protruding eyes and eyes opened too wide, all these three problems will require different eyelid & orbital surgery procedures to correct the eyes functionally and aesthetically. In the first stage of the surgery, the surgeon works to place the eye back in the eye socket (orbital decompression surgery); in the second stage, the patients get rid of the double vision by operating on the eye muscle (squint muscle surgery), while in the last stage they remove the excessive fat or skin from the eyelids and correct eyelid retraction as well (eyelid surgery).

Recovery

The recovery time depends on how many surgeries you’ve had. Each surgery requires a certain care, but usually, you need around two weeks to recover from each orbital & oculoplastic procedure. There are certain types of medications that should take after some surgeries, the doctor will tell you everything you need to know. Discuss with  your doctor about all kinds of medications that you have been taking before surgery.

FAQs

Why is it so important to know the stage of the Graves’ Disease?

It is highly important to know the stage of the disease, in order to take a treatment or go through a surgery to keep the symptoms under control. Surgery can’t be done in the first two stages, while anti-inflammatory medication does not work on the last stage. Also, the patients need to be constantly checked, because there is a risk of loss of vision in this disease. In the active inflammatory stage, there is a high risk of completely losing the vision, because of the troubles encountered while closing the eyelids, due to protrusion of the eyes, and the subsequent risks of corneal ulcer and exposure keratopathy.

Do steroid pills help during the active and the inflammatory stages of the disease?

The steroid pills and the orbital radiation both will help you reduce the symptoms. However, in order for them to work, they should be taken for a longer time, and therefore, steroid oral medication might come with some side effects such as weight gain or loss, insomnia, headaches or high blood pressure.

Are there any risks when it comes to the Graves’ Disease surgeries?

Just as in any other surgery, there are risks here too, of bleeding, problems of the vision, and more. If you come to The Esthetic Clinic however, all the risks should be discussed with Dr. Debraj Shome.

Cost

The costs depend on the type of oculoplastic surgery you need. The medications for the first two stages of the disease are cheap, but the cost of a surgery is generally higher. Everything should be, however, covered by the insurance company.

The Esthetic Clinic offers you the best treatment and the best doctors to take care of you. Dr. Debraj Shome is a trained oculoplastic surgeon, and one of the best orbital surgery experts in the world. Dr. Debraj Shom is not only very skilled at oculoplastic surgery, but is also at the forefront of research into complex orbital disorders such as Thyroid Eye Disease. Dr. Shome performs a very high volume of orbitotomies through various approaches (medial orbitotomy, lateral orbitotomy, anterior orbitotomy, etc) and orbital decompression surgeries (one wall, two wall, three and four wall decompression surgeries), every year. Given his training in Cosmetic surgery, he can make sure that both your eyes look as symmetrical as before, with a combination of oculoplastic, orbital and eyelid surgeries.