Eyelid Retraction in Graves’ Disease

In this week’s episode of Thyroid Thursday, Graves’ disease specialist, Dr. Raymond Douglas, talks about eyelid retraction in Graves’ disease patients.

What is eyelid retraction?

Eyelid retraction occurs when there is an abnormal elevation of the upper eyelid (so the upper eyelid rests higher above the cornea/iris) and/or there is an abnormal elevation of the lower eyelid (so the bottom eyelid rests lower below the cornea/iris). When there is eyelid retraction, this creates the appearance of bulgy eyes or prominent eyes.

What causes bulgy eyes? Why do my eyes appear so bulgy?

Eyes become bulgy for a combination of reasons related to both the eye itself and the eyelid. In terms of eyelid retraction in Graves’ disease, the two main reasons include:

  1. The eye is actually prominent and bulgy from the thyroid eye disease (Graves’ disease) itself. The disease causes the fat and muscle behind the eye to push the eye forward.
  2. The disease also attacks the muscles that open the eye and the muscle at the bottom of the eyelid and cause scarring. This in turn opens up the eyelid even more and creates the prominent or bulging eye appearance.

Eyelid Retraction Treatment

Dr. Douglas specializes in eyelid retraction surgery at the International Orbital Institute in Beverly Hills. When treating patients with eyelid retraction in Graves’ disease, there are generally two approaches he may take to make the eyes look normal again.

  1. Lower Eyelid Retraction – Surgically move the eye back into a normal position. Often times this is enough to fix the retraction in the lower eyelid. Dr. Douglas can also release the scar tissue of the lower eyelid all at the same time, if necessary, for best results.
  2. Upper Eyelid Retraction – When the upper eyelid is retracted, Dr. Douglas will make a little incision on the underside of the eyelid and release that muscle or even remove it in some cases. This helps the upper eyelid fall back into the appropriate place. Alternatively, he may make a little incision on the outer skin of the eyelid and that can also help to lower the eyelid and create a nice contour.

Dr. Douglas’ goal is always to achieve the best results in the fewest surgeries possible. While traditionally eyelid surgery needed to be done in several phases, Dr. Douglas is almost always able to correct eyelid retraction in a one-stage customized orbital decompression.

Contact Us Today!

If you are experiencing eyelid retraction due to Graves’ disease, please contact us today about a consultation. If you live out of town, not to worry, most of our patients do! Therefore, we have a very easy video consultation process so you can meet Dr. Douglas for the first time from the comfort of your own home. To schedule your video consultation, please contact us today.

Posted in: Thyroid Eye Disease

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