March 2019

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Orbital Decompression for Thyroid Eye Disease

An overactive or underactive thyroid can have a variety of detrimental effects on the body. Thyroid eye disease is a condition that occurs secondary to general thyroid disorder in which the inflammatory response of the immune system affects the soft tissues in the eye socket. This inflammation usually occurs in both eyes, though not necessarily symmetrically.

Thyroid eye disease is a complex process that occurs in stages. The inflammatory response in the tissue of the eye socket may last as long as two years and may develop in a person who hasn’t even been diagnosed with thyroid disease. In many cases, the early inflammation that occurs feels more like irritation and dryness. Within the eye, though, significant ocular involvement may be happening. As inflammation continues, additional symptoms may develop. These include:

  • Eye redness
  • Excessive tearing
  • Blurred vision
  • Double vision or an aching sensation with eye movements
  • Puffiness in the upper or lower eyelids
  • Aching deep in the eye socket
  • The appearance of staring or bulging eyes due to retraction of the upper eyelid

Treating Thyroid Eye Disease

Treatment for thyroid eye disease is planned very carefully and revolves around the disease state a patient is in at the time of diagnosis.

A mild, early disease state may be managed with prescription eye drops that control inflammation and comfort.

An active disease state may include specific treatment of the eyes as well as treatment to manage general thyroid function. The aim of treatment may be to lower the risk of eye bulging (proptosis) and visual disturbances related to protruding eyes.

If the active disease state has presented a significant concern for appearance or vision, an ophthalmic plastic surgeon who specializes in thyroid eye disease may conduct orbital decompression surgery. This procedure relieves pressure against the optic nerve and creates more space in the eye sockets for the eyes to sit properly.

Getting Proper Care for Thyroid Eye Disease

Fante Eye and Face Center is recognized as a premier facial cosmetic surgery practice in Denver. However, Dr. Fante is also renowned for his work in the area of thyroid eye disease and eyelid reconstruction procedures. His extensive training is complemented by his activity as editor-in-chief of the most comprehensive textbook ever created for the specialty of oculofacial plastic surgery. He has also lectured extensively on the subject of thyroid eye disease and successfully treated numerous patients with proptosis.

Learn more about the diagnosis and treatment of thyroid eye disease. Call our Denver office at (303) 839-1616.

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Why Eyelid Surgery Needs the Skill of a Specialized Surgeon

People undergo eyelid surgery for several different reasons. We commonly hear about the cosmetic benefits of eyelid rejuvenation on the upper or lower eyelids. While blepharoplasty is one of the most popular cosmetic procedures, eyelid surgery may also be necessary for functional reasons, such as to reduce symptoms related to an inward- or outward-turned eyelid. Eyelid trauma and skin cancer are additional reasons eyelid surgery may be performed.

When a surgical procedure is needed or wanted, it is vital that the operating surgeon has a depth of understanding of the complex eyelid structure. The eyelids have particular functional mechanisms, such as closing over the entire ocular surface in blinking and spreading the tear film across the eye. The lower eyelids are also involved in dryness prevention by holding tears in the eye until they naturally drain from tiny tubes in the lower area of the eye. Conducting surgery on either the upper or lower eyelid requires surgical savvy and careful execution.

Eyelids are More than Meets the Eye

The eyelids aren’t just pieces of skin that cover the eyeball, and an operating surgeon must recognize the complexity the lies beneath the surface. Structures that must be considered include:

  • Tissue lining. Inside of the eyelid is a smooth, soft lining that supports the lubrication of the eyes.
  • Muscle. Beneath the surface of the upper and lower eyelids is muscle tissue that enables the lids to move during blinking.
  • Cartilage. It is rigid cartilage tissue that keeps the upper and lower eyelids from drooping away from the eyeball.

Eyelid rejuvenation and reconstruction are procedures that must consider the value of every component of tissue in the eyelid, including how each function and supports the eye. The thickness of the tissue involved, as well as the location and size of the defect to be corrected, dictate the complexity of the procedure being performed. Dr. Fante is an esteemed, double board-certified facial plastic surgeon with years of training and experience performing some of the most complicated reconstructive procedures.

Treatment for cosmetic concerns and eyelid trauma is tailored to the needs of each patient. Prioritizing peace of mind, Dr. Fante conducts a thorough consultation and examination during which all of a patient’s questions can be answered.

For more information on eyelid rejuvenation with blepharoplasty or eyelid reconstruction, call our Denver office at (303) 839-1616.


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