Types of Thyroid Eye Disease


Thyroid Eye Disease, also known as Graves’ eye disease, is an autoimmune disease. Your immune cells attack the tissues around your eyes, causing the eye fatty tissue or muscles to swell and expand. This inflammation can cause the eyes to bulge or push forward, pain, puffiness, dry eyes and irritation, among other symptoms.

The type of thyroid eye disease a patient presents with is very important in considering the amount of proptosis (bulging of the eye) reduction and improvement that can be achieved, as well as the risk for double vision. There are two types of disease – fat predominant disease and muscle predominant disease.

Due to the complexity of the disease, it is very important to find a surgeon who has a thorough understanding of the different presentations of Thyroid Eye Disease, as well as extensive experience in orbital decompression surgery. At the International Orbital Institute, Dr. Raymond Douglas performs orbital decompression on hundreds of patients a year and is a true expert in the field. In the hands of Dr. Douglas, you can rest assured that you will get the best care possible.

Fat Predominant Disease

What is Fat Predominant Disease?

Fat predominant disease often presents with a high degree of proptosis, or very bulging eyes, but a very low chance of double vision. Fat predominant disease is generally seen in a younger patient population.

Fat Predominant Disease

Muscle Predominant Disease

What is Muscle Predominant Disease?

Muscle predominant disease occurs when the immune system attacks the muscles. Patients with this type of disease have varying degrees of proptosis. Muscle predominant disease does cause double vision and places the patient at a higher risk of having postoperative double vision. In most cases, more older patients present with muscle predominant eye disease.

Muscle Predominant Disease


Surgical Considerations for Each Type of Disease

Dr. Douglas has studied type of Thyroid Eye Disease and surgical implication in great detail and found that in 57 patients with fat predominant disease who had lateral and/or medial decompression there was less than 2 percent chance of double vision. These results show that no matter what type or how extensive the decompression was, the chance of double vision was very low in patients with fat predominant disease.

Comparatively, in patients with muscle predominant or mixed disease, undergoing lateral decompression alone had less than 5 percent chance of double vision, but undergoing medial and lateral decompression had approximately a 15 percent chance of double vision. Overall, these rates of double vision are extraordinarily low compared to other surgeons because we take meticulous care to reduce all factors that cause double vision. However, these statistics do demonstrate that the biology of the disease determines the risk, and, thus when evaluating a patient this is a very important parameter to consider.

View Renee’s Thyroid Eye Disease Journey

Contact Us

Contact The International Orbital Institute

If you or a loved one is suffering from thyroid eye disease, please contact the International Orbital Institute so we can help! Our mission is to provide our patients with personalized care so they can feel like themselves again! Our team of experts is here to evaluate your disease and develop a customized treatment plan to ensure you get the results you deserve. Please call us today to schedule your consultation – (310) 657-4302

For patients who live out of town, we also offer telemedicine consultations so we can speak via Skype from the comfort of your own home.

Call Our Office Today

(310) 657-4302

Send Us a Message

  • This field is for validation purposes and should be left unchanged.

Call Now Button
Translate »