I was diagnosed with hyperthyroid last 2010, and also suffered from Grave's disease. Now i am planning to undergo blepharoplasty because my upper lid is droopy any my eyes cannot fully close (there's a gap whenever i close my eyes) my lower lid also drooped a bit. my doctor said my eyes is way better than other patient suffering from grave's disease.Can blepharoplasty help solve my problem? thank You
Grave's Disease and Hyperthyroid. Will Blepharoplasty This Help Solve My Problem? (photo)
Doctor Answers 7
Please be very careful here.
Grave's disease is an autoimmune disease that affects the thyroid gland commonly producing an overactive thyroid. In addition, the immune process can stimulate the fat cells and fibroblasts in the orbit causing a constellation of eye changes that are collectively known as Thyroid related ophthalmopathy (TRO). The eye changes can range from subtle upper eyelid retraction to severe bulging of the eyes and even optic nerve damage leading to blindness. The more severe forms of TRO are fortunately rare with many more individual demonstrating minimal or no eye changes. The important point is that you should be very careful having eyelid surgery because the TRO can change over time. You need to be assessed by an oculoplastic surgeon with a great deal of experiencing managing TRO. Generally this will be a university based oculoplastic surgeon in a department of ophthalmology. Do not have cosmetic eyelid surgery unless specifically cleared for this surgery by the oculoplastic surgeon who is managing your TRO. This will keep you out of serious trouble.
This is a grave decision and one that should be evaluated by your physicians. It is usually not recommended to perform blepharoplasty on patients with your condition.
Hold off on surgery for now.
Based on the photos you have presented, you do not have a droopy eyelid. And if you are already experiencing difficulty closing your eyelids, a blepharoplasty may even make things worse.
Surgery should not be done until your surgeon is absolutely sure that the Thyroid Eye Disease [Thyroid Orbitopathy] is completely stable, and this done by serial exams over months and maybe over a year.
If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website
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Not being able to close our eyes is not a good sign. It is probably likely that you are a candidate for something other than a straight forward bleph. Please consult a plastic surgeon that specializes in OCULOPLASTIC SURGERY.
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Because you have Grave's disease, you need to be very careful as your situation is different from patients without hyperthyroidism. The solution to your problem will depend on the thyroid related changes you are experiencing in the eyes, and an in-person evaluation is warranted. You will need to seek a board certified oculoplastic surgeon specializing in thyroid related ophthalmopathy in your area to assist you and coordinate your care with your endocrinologist.
Grave's Disease and Hyperthyroid. Will Blepharoplasty This Help Solve My Problem?
Since you have Graves' disease, I strongly recommend you see an Oculoplastic surgeon (who specializes in treating Graves' disease patients) before undergoing any procedure. Surgery can be helpful but is complex in this type of situation.