The Eye of Thyroid!

This lady walked into my clinic wondering what’s wrong with her right eye. It had gradually started protruding forward, she wasn’t able to close her right eye fully and she had double vision in all gazes.

At Presentation

The diagnosis was quite straightforward. She was suffering from the after effects of a disease called Thyroid Eye Disease (TED). It is an auto-immune disease where antibodies cause sometimes severe inflammation in Thyroid as well as the eyes causing both short and long term sequelae to the eyes and thyroid. As my mentor would say to his TED patients, “Your Thyroid and the Eyes are the victims of the same disease”.

CT Imaging revealed a Muscle dominant Thyroid Orbitopathy.

CT Scan

The severe ones are fairly easy to diagnose but still challenging to treat. In nearly a third of the cases of TED, there is an almost sub-clinical course of the active phase of the disease and only recognised by the after effects of TED like in this lady. She presented with Right Eye Proptosis, upper and lower eyelid retraction

A right orbital 3 wall decompression was done via bone removal from medial, lateral and floor of the right orbit with conjunctival and eyelid crease incision thereby providing nearly symmetrical outcome.

Shows the before and after surgery photos

Comparison betweek Pre and post operative CT Imaging revealed good and adequate correction

The picture below documents the patient’s journey from before TED to after Surgery

Isn’t this transformational?

⏲Surgery time: 90 mins
💉Anaesthesia: General Anaesthesia
🗓️Downtime: 4 weeks
📈Duration of effect: Permanent
📠 Phone: +91 80 2502 3257
🖥️ Website:

The patient chose not to go ahead with correction of right lower lid retraction as she was thrilled with the outcome already!

While acute symptoms have debilitating morbidity with sight threatening features, the after effects of TED can have long lasting eye abnormalities like protruding eyeballs, squint, staring look and inability to close eyes causing eye dryness. Surgery can take care of many of these after effects.

Consult an oculoplastic surgeon if you or anyone you know has this condition.

Published by Dr. Raghuraj Hegde

Free thinker| Poet| Writer| Traveller| Doctor| Ophthalmic Plastic Surgeon

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