This lady came to see me for a second opinion. The diagnosis is not the issue…it is clear she has thyroid eye disease or thyroid associated orbitopathy (Tao).
She has proptosis, upper lid retraction and lower eyelid retraction.
The key is swelling…the most common cause of orbital swelling is thyroid immune orbitopathy.
She was quite distressed, as nothing had been done for a year and she felt it was progressing.
Thyroid disease can present quickly, but it can also present slowly, and slow change can be hard to measure (can you see the hour hand on a clock move???)
Low dose orbital radiotherapy
I have sent her for low dose orbital radiotherapy which will bring the orbital component of the disease to a halt.
There are chemotherapy agents that can be used, but none of them measure up to the effectiveness, safety and speed of low dose radiotherapy.
Once settled, I can reposition her eyes with stereotactic orbital decompression surgery.
More information available at www.oculoplasticsurgery.com.au
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