The Thyroid Eye Institute offers a wide variety of options to improve conditions resulting from thyroid eye disease including bulging of the eyes, puffiness, redness, pain, dryness, irritation, and closed eyelids.
Thyroid eye disease (TED), also known as Graves’ ophthalmopathy, is an autoimmune disorder that causes inflammation and swelling of the eyes and can stimulate the production of muscle tissue and fat at the back of the eye. This infection tends to cause frustrating and uncomfortable issues, such as red eyes and eyelids, swollen skin, and bulging eyes.
The tissue around the eye is usually the main target for thyroid eye disease, resulting in inflammation and swelling which also causes:
As TED symptoms tend to be progressive, if swelling continues without treatment, additional symptoms can include:
Thyroid eye disease, also called Graves disease, can cause inflammation that results in swelling and damage to the eyelid muscles. This can cause proptosis, or eyelid retraction where the eyelids are pulled back from the front of the eye. Dr. Paul performs eyelid retraction repair with orbital decompression surgery, a procedure that removes the bones and sometimes fat in the eye orbit in order for the eyes to be adjusted back to a more normal position.
To improve upper eyelid retraction, surgical loosening of the upper eyelid retractor muscles (levator muscle and Mueller’s muscle) and release of scar tissue in the muscles is performed to allow the upper eyelids to come down to a more normal level. This surgery is typically done with local injections and minimal IV sedation in order to permit patient cooperation during the surgery. Patients are placed in a sitting upright position at the end of surgery to ensure adequate surgical correction. Adjustments made during surgery diminish the risk of asymmetry following surgery. Despite meticulous attention to eyelid height during surgery, the eyelids may heal differently resulting in eyelid asymmetry.
Frequently, the asymmetry is not bothersome and further surgery can be avoided. In up to 10-15% of patients, additional “touch-up” procedures may be needed to correct significant asymmetries. Significant upper eyelid retraction repair is typically considered medically necessary, and is usually covered by most insurance carriers. Mild cases of eyelid retraction may be considered cosmetic. At the time of upper eyelid retraction repair, patients may elect to have excessive fatty tissue and redundant skin folds excised. Upper eyelid blepharoplasty is frequently considered cosmetic, and is not typically covered by most insurance carriers.
Orbital decompression surgery can often improve proptosis by enlarging the eye socket (orbit) to accommodate the swollen fat and muscle tissues behind the eye. This allows the eye to settle back into a more comfortable position. The consistency and amount of fat varies from case to case, and will impact the degree of decompression achieved by surgery. Individuals with thicker, stiffer fat may not experience as much decompression effect as those with large amounts of softer, more fluid-like fat tissue.
Around the orbit (the bone socket in which the eyeball sits), there are a number of sinus cavities that can be used to surgically expand the orbit. The sinus below the eye is called the maxillary sinus, and the sinus toward the nose is called the ethmoidal sinus. A maxillary-ethmoidal bone decompression is a well-recognized approach for accommodating the extra tissues behind the eye. Most people only require a two wall, maxillary-ethmoidal decompression; occasionally, the outside (lateral) wall of the orbit may also be removed.
Tepezza is an FDA-approved prescription treatment for thyroid eye disease. It is delivered intravenously on-site at The Thyroid Eye Institute in a multi-session treatment schedule over the course of a few weeks. Tepezza has proven very effective in:
Dr. Sean Paul is the founder of Austin Face & Body. As a widely published surgeon who has traveled all over the world to speak, Dr. Paul is renowned and highly regarded in his industry. He specializes in cosmetic and reconstructive eyelid and facial plastic surgery in Austin, and is board certified by the American Board of Ophthalmology.
Dr. Sean Paul is a highly experienced master ophthalmologist specializing in eye surgeries of all kinds, including those required to treat thyroid eye disease and its effects. Providing the highest level of patient care and results, Dr. Paul remains abreast of all research and innovation in his field, and is proud to be able to offer Tepezza and other options to his Austin patients. If you’re looking for a renowned Austin ophthalmologist to help you treat and correct TED, please schedule a consultation with us at The Thyroid Institute at 512-559-3544, or contact us online.
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