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Surgery for Thyroid Eye Disease: Cosmetic and Functional Benefits
Thyroid eye disease (TED) is an autoimmune condition in which the body’s immune system attacks its own tissues by mistake. In this case, the immune system targets the eye muscles and fatty tissue behind the eye, which become inflamed. This inflammation can push the eyes forward, making them appear bulging, or cause the eyes and lids to become red and swollen.
When inflammation involves the eye muscles, it can cause the eyes to become misaligned, leading to double vision. In rare cases, TED can lead to blindness from pressure on the optic nerve or ulcers developing on the cornea.
TED is primarily associated with an overactive thyroid gland caused by Graves’ disease; it rarely occurs with an underactive or normally functioning thyroid gland. About one-quarter of patients with Graves’ disease develop TED before, during, or after being diagnosed with a thyroid disorder. TED is also termed Graves’ orbitopathy (GO) or Graves’ eye disease (GED).
At Arizona Ocular and Facial Plastic Surgery, oculofacial plastic and cosmetic surgeon Dr. Dustin Heringer treats TED in patients at our Peoria and Scottsdale, Arizona, offices. Understanding the disease is important for knowing when surgery is necessary or when conservative symptom relief is best. Here, the doctor explains.
How does TED manifest?
Thyroid eye disease has two phases: active and stable. During the active phase, inflammation and swelling of the eyes reach their peak, and treatment focuses on relieving symptoms. This phase can last up to two years.
During the stable phase, both the inflammation and swelling subside, allowing the doctor to perform surgery, if needed, to correct any visible effects of the disease and restore vision.
Symptom relief
During the active phase, Dr. Heringer helps alleviate symptoms in a number of ways:
He may offer medicated eye drops and anti-inflammatory corticosteroids to quell the swelling.
Swelling may be severe enough to prevent you from fully closing your eyes, which can result in corneal ulcers that can cause vision loss. We can show you how to make dressings to place over your eyes while you sleep. These dressings trap moisture and prevent the dryness that leads to corneal ulcers.
The doctor may recommend reducing the amount of salt in your diet and sleeping with your head raised. Both decrease eye swelling and can help preserve your vision.
Treating stable TED
Once the swelling has subsided, Dr. Heringer can perform a series of surgeries to correct bulging eyes, double vision, and any physical changes that have occurred within the eyes. These allow you to enjoy improved vision with less discomfort.
Surgeries to treat TED include:
Eyelid surgery
When the eyelids are tight, they prevent the top lid from coming down and the bottom lid from moving up, leading to dehydration of the eyes and corneal damage. Eyelid surgery (blepharoplasty) may make it easier to keep your cornea covered.
Eye muscle surgery
The doctor may recommend surgery to move the position of your eye muscles, which can help correct double vision. You may need more than one surgery to see full results.
Orbital decompression surgery
This surgery relieves the pressure on the optic nerve by making the eye socket larger or removing excess tissue. It also lessens the bulging of the eye caused by the disease. If Dr. Heringer recommends other surgeries (eyelid, eye muscle), he usually performs the orbital decompression first.
If you’re having multiple surgeries, Dr. Heringer performs them in stages, lasting 2-4 months between each procedure. That provides enough time for your eyes to heal properly. While some patients may see the results they’re after with just one surgery, most require more than one.
At your consultation, Dr. Heringer will evaluate your unique situation and determine which cosmetic surgeries will best suit your aesthetic goals.
Patients often benefit from face lifts and blepharoplasty because they tighten loose skin on the face, neck, and eye area, creating a younger appearance. Also, a range of minimally invasive skin treatments and injectables can reduce the early signs of aging, such as wrinkles and fine lines around the eyes, enhancing your appearance post-thyroid eye disease treatment.
If you’re experiencing the unpleasant symptoms of thyroid eye disease, help is a call or click away. Call us at either location or book online with us today.
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