Can Botox Be Used to Improve the Appearance of Proptosis in Thyroid Eye Disease?

Proptosis is bulging of the eye anteriorly out of the orbit.  If this is also resulting in lid retraction then botox could be used to cause ptosis (droop of the upper eyelid) which can in effect "mask" or make the bulging eyes less apparent.  I don't think botox would help with lower lid retraction however.  It would be difficult to predict the degree of droop the botox would produce and if it drops so much that it blocks the pupillary axis you would have a difficult time seeing.  This is usually not a recommended method of managing proptosis.   If you are in Birmingham, I would recommend seeing Dr. John Long - an oculoplastic surgeon.

To the best of my knowledge, botox cannot be used to improve the appearance of proptosis in Thyroid Eye Disease

I do not see how the globe of the eye can be repositioned by botox injections.If the eyelid muscles are weakened then the forward projection of the eye could be made worse.