Do I Need Surgery to Treat Thyroid Eye Disease?

The symptoms of thyroid eye disease or Graves’ disease can occur quickly and without notice. The onset of these symptoms, including proptosis, or eye-bulging, can create a great deal of concern. Thyroid eye disease results from an autoimmune disorder that makes the body believe the thyroid gland is a foreign invader and something to attack. While one aspect of treatment is to address the autoimmune disease, another is to protect vision. Appropriate ophthalmic care can do that, as well as preserve or restore the natural appearance of the eyes. 

Surgery is rarely the first approach to treating thyroid eye disease. When the condition is detected early, a doctor may prescribe eye drops or gel. For acute cases with severe symptoms, a doctor may prescribe a course of high-dose steroids that gradually decreases over days or weeks. An ophthalmologist may be brought into the case plan when TED has reached a chronic stage in which its progression has stabilized and the bulging can be corrected with surgery. 

Thyroid Eye Disease Surgeries

The purpose of thyroid eye disease surgery is to correct some degree of the damage that may have been caused by scarring. A surgical procedure can help correct multiple symptoms of TED, including retracted eyelids, double vision, bulging, and misaligned eyes. The challenge that thyroid eye disease presents is that the desired degree of correction may not be achieved in the first surgery. Some patients may need multiple eye surgery to improve vision and appearance. These procedures may follow a specific order. 

Orbital Decompression Surgery

As it sounds, orbital decompression surgery is performed with specific objectives. These include:

• Improvement of eye comfort.
• Better eyelid closure to cover the ocular surface.
• Improved appearance, less bulging of the eyes. 
• Relief of optic nerve pressure.
• Some degree of improvement of double vision, if possible. 

Orbital decompression surgery is usually performed using endoscopic techniques, which utilizes small incisions. The objective is to create room behind the eye for the enlarged muscles that form due to TED. To do this, the surgeon may sculpt a section of bone posterior to the eye globe. Fatty tissue may also be modified so that the eye can sit in a proper socket. 

In addition to orbital decompression, some patients need further surgery to correct the effects of thyroid eye disease. Some may need strabismus surgery to correct double vision, some may need a subsequent procedure to reposition the eyelids. Face sculpting may also be beneficial, via surgical techniques or injectable treatments.

 

Ophthalmic Plastic and Cosmetic Surgery Inc. has offices in St. Louis and St. Peters. Contact us to schedule your consultation for thyroid eye disease surgery.