Repair of Disfiguring Eyelid Retraction Resulting from Grave's Disease. Austin, TX

I was diagnosed with Grave's disease in the summer...

I was diagnosed with Grave's disease in the summer of 2014 after months of symptoms that grew progressively worse. When my endocrinologist told me I had Grave's, I couldn't help but cry because I feared my eyes and face would become disfigured. My doctor told me not to despair because "there's surgeries to get the eyes back to normal," but that was little comfort, as thyroid eye disease is an imprecise waiting game that often cannot be treated for years, due to the inflammatory nature of the disease.

Unfortunately, as I had feared, my eyes did change over time, especially my right eye, and there was nothing I could do about it (as I was already a non-smoker). My right, upper-eyelid became increasingly retracted, and at its worst, the eyelid was essentially hidden within its own fold. My left eyelid also retracted, but only slightly. My eyes became asymmetrical, looking startled on one side, and heavy/puffy on the other, a result of my lids trying (and failing) to coordinate their movements.

These changes caused me extreme distress. Every day I felt self-conscious in speaking with others, and I didn't recognize myself in the mirror. I tried to hide behind glasses and my hair, but realistically, there was nothing I could do to hide the condition of my eyes unless I wore sunglasses 24/7, which wasn't an option. I read for hours about the disease and looked at before/after photos, wondering what would become of me and whether I'd ever recognize myself again.

I started researching who may be able to correct my eyes, and I even contacted experts in other states. But Dr. Nakra was recommended to me by a thyroid eye disease specialist in Michigan, so I was hopeful that I could possibly get excellent treatment in Austin.

It was easy to get an appointment with Dr. Nakra, and I didn't have to wait for weeks to be seen. During our early consultations, he was very honest about the state and possible progression of my condition and the kinds of treatment options to keep in mind. Fortunately, he predicted that I could have a satisfactory result with eyelid retraction repair instead of needing orbital decompression surgery because my retraction wasn't an extreme case. I felt very relieved to hear this and for the first time in months, I felt some optimism about my condition. I no longer felt I was at the mercy of this disfiguring disease.

I made regular visits so Dr. Nakra could measure and record whether my eyelid retraction was improving or worsening. My vision was also thoroughly tested to ensure my orbital nerves weren't damaged. At every consult, we discussed my eventual surgery, and I'm certain that I asked particular questions multiple times. Dr. Nakra was always very patient and explained in-depth what I would experience, as well as the statistical likelihood of certain outcomes. He had a clear, substantive answer for every question I asked but was also forthcoming when he couldn't promise certain outcomes. Even in those cases, however, he did his best to make educated, responsible guesses, which I appreciated.

Dr. Nakra also never tried to downplay the sense of distress and anxiety I felt as a result of my eyes, and he told me it was normal to feel this way. At the same time, he discussed the topic in a calm, relaxed manner, thereby avoiding any heightening of the unease I was feeling.

Fortunately, my eyes stabilized around the fall season of 2015, meaning the retraction and swelling had not worsened in months. This also meant I had finally become eligible for surgery.

|The Mullerectomy|
Dr. Nakra explained that he would sever a few tiny muscles underneath my eyelids so that there would be less tension on the lids, and they'd be able to close more fully. My eye disease had caused scarring and tension along orbital levator muscles behind my eyes, so lessening the tension of the eyelids would create symmetry without having to perform invasive surgery. Further, this would be accomplished by flipping the lids inside-out, then severing the muscles, rather than creating an incision on the lids. I would have no visible scarring.

This would all be accomplished under twilight sedation, in less than an hour of actual surgery, and would then require a couple weeks of recovery, due to swelling, bruising, and somewhat limited movement (bending over was prohibited, as it would exacerbate swelling). Also, Dr. Nakra had been gracious enough to try to schedule my surgery ASAP so I could recover during Thanksgiving and have serious improvement by Christmas.

I was nervous about the surgery, not because of Dr. Nakra's skills (he had already performed thousands of surgeries), but because I was nervous about the anesthesia. But an anesthesiologist was present, as were the necessary emergency measures, in case I had an allergic reaction to the anesthesia.

I don't recall any discomfort related to the surgery or recovery room. The environment was calm and unhurried, and my pain was properly managed. I was able to walk back to my car with assistance after a relatively short recovery and spent the next two days dozing in and out of consciousness due to the anesthesia and pain relievers. A nurse called to check on me, and I was progressing as expected. My eyes (especially my right) looked swollen and discolored, and they kept tearing and weeping blood and fluid, but I expected as much.

Week by week, the appearance of my eyes improved and became more symmetrical as my lids' swelling subsided. It didn't take long before I needed only good concealer to hide my bruising. Surprisingly, it was difficult for me to adjust to my eyes' looking more normal, and I looked at them endlessly, trying to gauge their improvement.

Thankfully, I looked much better within a matter of weeks. In fact, not even a month had passed since my surgery, and a new acquaintance complimented my eyes at a holiday event. It was the first compliment I'd received on my eyes in two years, and I felt so relieved that my face was returning to normal. I no longer had to hide my face or worry about what people were thinking of my eyes.

If someone needed a surgeon to correct the appearance and functioning of their eyes, I would definitely recommend them to Dr. Nakra. I am very happy with the results of my surgery and thank Dr. Nakra immensely for using his expertise to return my appearance to normal.

Austin Oculoplastic Surgeon

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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