Thyroid Disease and Ocular Symptoms
Simply put, when thyroid disease occurs, there is frequently an immune response from your own body that targets receptors in your orbital fat (eye socket fat) and muscles. As these receptors are activated, an inflammatory cascade occurs that creates the symptoms described above. In these cases, often patients are referred to Dr. Brock for evaluation and treatment. Thyroid eye disease is a serious condition that requires the attention of an experienced oculoplastic specialist who understands the science, treatment and also the emotional toll on patients who are afflicted by thyroid eye disease.
Treatment for Thyroid Eye Disease
Historically, any medical treatments have had limited or sometimes only short-acting improvement on thyroid eye disease. IV steroid therapy can be helpful in some cases, but most often are used as “rescue” drugs to prevent vision loss until surgery can be performed. They do play a role in preventing progression at times. Orbital radiation can be helpful in some instances to arrest the inflammatory process and prevent further progression. Only recently has a drug been developed specifically indicated for thyroid eye disease. This drug is called Tepezza (tprotumumab-trbw). Tepezza is a new generation drug that has never been available until now. Some patients have progressive swelling, proptosis, redness, pressure or vision loss. Thyroid eye disease can exhibit a progressive inflammatory phase initially, and then ultimately progress to a fibrotic phase where fibrosis and irreversible damage occurs. It is during the progressive inflammatory phase that tepezza is indicated. Tepezza blocks a receptor (IGF-1R) and inhibits fibroblast activation. Arresting the fibroproliferative phase results in 1) reduced inflammation, 2) prevention of muscle and fat tissue remodeling, 3) and prevents tissue expansion behind the eye.
Surgical Options for Thyroid Eye Disease Patients
When medical modalities fail, or only improve a patient’s condition to a point, surgery may be an option. There are three surgeries that are commonly performed: 1) orbital decompression, 2) strabismus (eye muscle) surgery, 3) upper and lower eyelid recessions. Orbital decompression is reserved typically for patients who have so much inflammation of the fat or muscles in the orbit that their optic nerve is being compressed, threatening their vision, or the pressure in their eye is too high, also threatening their vision. Dr. Brock is one of the few surgeons in the state who is qualified and experienced to perform orbital decompressions. Strabismus surgery is used to realign muscles; the goal is to create monovision (correction of the double vision) in straight ahead gaze and reading gaze by adjusting the muscles that move the eye. Eyelid recession is used to lower the upper eyelids or raise the lower eyelids, or both, in order to better protect the ocular surface.
Why Choose Dr. Brock
Dr. Brock can evaluate and diagnose your condition.He can explain where you are in the progression of your thyroid eye disease. He can guide you as to what treatments would be suitable and whether you need urgent intervention to protect your eye site and function of your eyes. If you are worried about changes occurring to the function or appearance of your eyes, get some peace of mind and contact our office today for help. Hang in there; help is here. We guide and assist many patients through this challenging time, to a better future!
I absolutely love Dr. Brock and the entire staff at Arkansas Oculoplastic Surgery. While any type of surgery, especially involving the eye(s), can be concerning or frightening.