Thyroid eye disease has many different symptoms and presentations.
Fortunately, most patients with thyroid problems will not experience any eye problems. For those unfortunate few that do, only 10% will have a severe enough eye problem to require urgent intervention or surgery. Most patients who develop eye problems have an overactive thyroid (hyperthyroidism or Graves’ disease). A minority will have an underactive thyroid (hypothyroidism) or euthyroidism (normal thyroid hormone levels).
Typical eye problems related to thyroid imbalance include an inability to blink or close the eyes completely, a staring appearance, bulging eyes, dry red eyes, double vision, vision loss, and pressure type eye pain. Normally thyroid eye disease will burn itself out in 2-3 years. However, it is important to be evaluated early on in the disease process as soon as any eye symptoms develop.
Dr. Schiedler will determine how frequently the eyes need to be monitored, and work closely with the endocrinologist who manages the hormonal imbalance. While most cases can be managed without surgery using supportive and comfort measures, or using steroids, there are some cases that do require eyelid or orbital decompression surgery. Dr. Schiedler may recommend removing bone and/or fat around the eyes in order to improve symptoms such as vision loss from compression of the optic nerve, or to reduce orbital pain and eye exposure problems.
Sometimes rehabilitative surgery is best accomplished in stages, starting with the eye socket to improve the position of the eye, then possible muscle surgery to align the eyes, and finally eyelid surgery to help them close better.