Thyroid eye disease and Orbital Decompression
What is thyroid eye disease?
What are the symptoms of Graves' eye disease?
The inflammation that occurs to the tissues around the eye cause:
- Redness of the eyelids and the eye
- Pain at rest or on eye movement
- Swelling of the eyelids, eyeball
- Bulging of the eyes
- Dry eye and irritation
- Increased pressure within the eye socket
- Double vision from swelling and scarring of the eye muscles
- Decreased vision
How do you treat bulging eyes from Graves' disease?
Mr Ahmad Aziz in his London clinic believes the best treatment to prevent bulging eyes it to prevent it in the first place. This is achieved by ensuring
- The thyroid gland hormones are in balance with medication as soon as possible to treat the thyroid disease.
- Making sure that you stop smoking if you are a smoker as this can make the condition worse and last for a longer period of time.
- Taking selenium supplements in mild cases which is shown to improve outcomes
- Treating active disease early with corticosteroids. Taken intravenously is less convent but is shown to result in fewer Cushing’s side effects.
- Considering autoimmune condition medications early if steroids do not help, examples of this include a medication known as Mycophenolate Mofetil or Azathiaprine.
- Radiation therapy or orbital radiotherapy to the eye sockets in severe cases where the person affected is over the age of 30.
- Avoiding radioactive iodine treatment for their Graves’ disease if they already have significant signs of ophthalmopathy.
- Considering orbital decompression surgery to restore the position of the eyes if there is bulging already, there is no longer an underachieve or overactive thyroid gland and the eyes have been stable for many months.
Does everyone with graves get bulging eyes?
How do you get thyroid eye disease?
What is the treatment?
Is the disease permanent?
Does thyroid eye disease go away?
How long does it take for the disease to burn out?
What is an orbital decompression?
- A unilateral wall decompression is where one wall of the socket is decompressed – most commonly the lateral wall or medial wall.
- A lateral wall decompression is a surgical treatment where an incision is made at the lateral aspect of the eyelid in the skin crease or the corner of the eyelid known as the lateral canthus to access the bony wall. Care is taken to not disturb the lateral rectus muscle which helps move the eyeball.
- A medial wall decompression is a surgical technique where an incision is made on the inside of the eyelid near the nose behind a bony landmark known as the posterior lacrimal crest. The medial wall is then accessed and the bone is removed. The medial wall can also be accessed with endoscopic sinus surgery. This form of endoscopic orbital decompression is most commonly used in the rare case of compressive optic neuropathy which results in a reduction in visual acuity and visual loss.