Thyroid Eye Disease

Management of Thyroid Eye Disease

Most patients with Grave’s disease, an autoimmune condition characterized by an over active thyroid, will develop mild eye changes over the course of their disease. Some patients with other thyroid conditions, such as an under active thyroid or a sudden inflammation of the thyroid, may also develop eye changes. Typical signs and symptoms include bulging of the eye, abnormal shape of the eye, double vision, pain and pressure behind the eye, glaucoma, and rarely, loss of vision due to pressure on the optic nerve. Typically both eyes are affected but often the involvement is asymmetric (one eye more affected than the other). When the eye changes are beginning to occur, which is most often within a year of diagnosis of the Grave’s disease, this is called the active phase of thyroid eye disease. Most cases are mild and will require only supportive measures until the eye disease stops on its own. Sometimes patients will have vision-threatening changes during the active phase and will require treatment with corticosteroids, radiation or other medication. Rarely, surgery to decompress (make more room inside) the orbit is necessary. This is called an orbital decompression and involves the removal of some bone to make more room for the eye and its associated tissue. In the inactive stage of thyroid eye disease, and depending on the severity of the eye changes, patients may require medical or surgical treatment. Thyroid eye disease may recur over time, and smoking has been proven to make it worse. Patients with thyroid eye disease should be examined regularly by an orbital specialist.

Orbital Decomopression

Orbital decompression is a surgical procedure used to help create additional space in the eye socket so that an eye that is pushed forward can return to a more normal position. Most commonly performed for thyroid-associated eye disease, this procedure takes place in an operating room under general anesthesia. For evaluation of orbital decompression surgery in Connecticut contact 203-791-2020 to schedule an appointment with our oculoplastic surgeon, Katherine J. Zamecki-Vedder, MD, FACS.