Graves’ Disease, Thyroid Orbitopathy, or thyroid eye disease, is an autoimmune inflammatory disorder of uncertain etiology. The disease affects the tissues of the orbit, like eyelids and extraocular muscles, as well as other tissues surrounding the eyes. Patients with this disorder often have an associated thyroid abnormality, which may manifest either before, during, or after the orbital signs and symptoms. However, please note that a rather small percentage of patients may have eyelid and orbital manifestations of the disorder without actually developing a thyroid abnormality.
Patient Before and After Bilateral Orbital Compression Surgery (Graves’ Disease).
The disease can develop and affect patients with varying degrees of severity. It can begin suddenly and progress rapidly, or start insidiously and progress gradually over a long period of time. The majority of patients experience mild inflammation, often involving retraction of the upper and/or lower eyelids, and bulging of the eyes. In cases where the inflammation is moderate, patients may also have varying degrees of double vision, eyelid swelling, and visible redness of the lids and eyes. Although rare, a small percentage of patients with thyroid eye disease may develop severe inflammation, which can result in compression of the optic nerve and permanent vision loss.
However, in most cases, the inflammatory process is self-limited and usually lasts between six months and a year before subsiding. Once the inflammation subsides, scarring of eyelid and orbital tissues may result in the persistence of eyelid retraction, proptosis, and double vision.
While the symptoms and signs of the disease vary, common symptoms include:
- Weight loss
- Rapid heart rate
- High blood pressure
- Nervousness & sweating
- Frequent bowel movements
- Thinning hair
- Muscular weakness, particularly in the legs
- High thyroid hormone level
- Protruding eyes and/or eye changes
- Double vision
- Sensitivity to light
Once the inflammatory phase of the disease subsides, patients with eyelid abnormalities, double vision, or proptosis may be eligible for surgical correction to improve their function and appearance.
The first stage of therapy is usually orbital decompression to reduce proptosis. This is done by expanding the eye socket, which allows the eye to move back. This is an outpatient procedure, which Dr. Taban performs using the latest minimally invasive techniques. Second stage surgery is for those with restrictive strabismus, causing double vision not corrected by prism glasses. The third stage operation is reconstructive and cosmetic eyelid surgery, which is commonly performed because eyelid retraction causes elevation of the upper eyelids, giving a “stared” look appearance. Luckily, this appearance can be corrected.
If you are suffering from Graves’ Disease, schedule a consultation with Beverly Hills oculoplastic surgeon Dr. Taban by calling (805) 669-9101 today.
Dr. Mehryar (Ray) Taban is one of the few board certified surgeons who is a member of the American Society of Oculofacial Plastic and Reconstructive Surgery (ASOPRS), diplomat of the American Board of Cosmetic Surgery (ABCS), and the American Board of Ophthalmology (AAO or ABO). Dr. Taban specializes in eyelid and facial plastic (cosmetic and reconstructive) surgery. He uses the latest technology in surgery, including minimal incision techniques, to provide quicker recovery times and natural outcomes. Learn more about Dr. Taban here.