Advice for an Opthalmologist Needed

[net123]

I am 24 years old and around 6 years ago, I have experienced an eye lid retraction of both eyes but especially my right eye. My upper eye lid of the right eye had retracted all of a sudden however after a few days it came back to normal or nearly. My lower eye lid however is still slightly retracted and my lower right eyelid is a bit more retracted than my left one. My undereye area is bit puffy but just a little bit and since this occured, my skin around the eye became weak and dark too and with a few wrinkles.


I had done thyroid tests after this event but results were normal.


I thought that Orbital Decompression would help but this is just my thought.
Since then I have noticed little improvement. Could you kindly give me some advice and let me know if there is some procedure can be doen and as well costs. I am from Europe... do you have suggestions for Doctors in Europe but the most important think is to have a very good professional, even if it is in America, I would not mind.  As well do you know of any insurance which could help financeially if I had to undergo this operation.

[jkhl]

Can orbital decompression be performed if a person has protruding eyes but do not suffer from graves disease?

[John C Hagan III, MD, FACS, FAAO]

The gel is not at all likely to have caused the problem.

Normally more than removing fat is done either opening the floor of the orbit or into the ethmoid and sphenoid sinus to allow fat to herneate into the sinus.


If you've had the problem 6 years its not likely to get a lot worse.

JCH MD

[net123]

It was a cosmetic eye gel to prevent wrinkles that I was applying incorrectly on the eye lids instead of below the eye area as it should be applied.

Could an orbital fat only decompression without removing any orbital bone help?
(my right eye slightly protudes more than my left one)

I am visit an eye specialist in UK next month for a check up and I will discuss with him if an orbital fat decompression can help and then I will decide whether to go for the decompression or for surgery to improve my lid recession.

Do you think that there is a good chance I do not develop hyperthyroidism if my eye problem has occurred more than 6 years ago?



Best Regards & Thanks

[John C Hagan III, MD, FACS, FAAO]

The severity of Graves eye disease does not always correlate with blood levels of thyroid hormones and markers.

glaucoma is an unlikely cause.

What was the gel?

JCH MD

[net123]

Me again... may I ask you another question please?

Could the puffy eyes and lower lid recession be a glaucoma issue or is it more likely to be TED?


Many thanks once again!

[net123]

Thanks a lot for your comment!

Is there a way thyroid level in tissues can be measured since I know that sometimes even though blood tests results are in normal range, one might still be effected by thyroid disease?

Next week I am scheduled for an iodine uptake scan of the thyroid... can this show clearer results than the blood test?

I am planning to come to US early next year for an orbital rim implant and/or alloderm graft  surgery to correct my problem of lower rid recession and before deciding whether to do this , I wish to find out if graves eye disease is my problem or not.

I would like to mention as well that before all this started I had been applying a eye gel on my lids and first this cause my lower lids to flake and then got puffy undereyes and after the retraction.... Could it be the cause of all this was this eye gel?


Sorry for all the questions and many thanks for your help!

[John C Hagan III, MD, FACS, FAAO]

I would keep watch for thyroid diseae in the future as it is far and away the most common reason for this to develop.

The most likely  treatment if its indicated would not be orbital decompression but eyelid retractor recession.


You need to see an oculoplastic surgeon. I don't know any in Europe. In the USA any of the top medical programs John Hopkins, Bascom Palmer, Mass Eye and Ear,  Washington U, Emory, etc will have well trained people.

JCH MD