Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Oculoplastic Surgery Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
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Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Thyroid
Eye Disease
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
  Thyroid Eye Disease view before & after photos   
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery

Thyroid eye disease, more technically named Graves ophthalmology or Graves orbitopathy, is an inflammatory disorder of the tissues within the orbit or eye socket (i.e., including the orbital soft tissues, eye muscles, eyelids, and conjunctiva). Patients with this disorder often have a thyroid abnormality that may manifest itself either before, during, or after eye symptoms begin.

Signs and Symptoms

Graves ophthalmopathy can have a wide variety of presentations and severity. The disease can begin suddenly and progress rapidly over days to weeks or can start slowly and progress gradually. The majority of patients have mild symptoms, mainly with retraction of the upper and lower eyelids and bulging of the eyes (proptosis). More moderate cases have increased inflammation with visible redness of the eyes, eyelid swelling, and varying degrees of double vision (diplopia). A small percentage of patients have severe inflammation that can result in compression of the optic nerve ad permanent vision loss.

In most cases, the inflammation worsens over the first 6 months to a few years before subsiding spontaneously. Changes caused by scarring of the eyelid and orbital tissues may persistent, resulting in persistent proptosis, eyelid retraction, and/or diplopia.

Evaluation and Management

Patients should be evaluated by an ophthalmologist to assess the extent and severity of the eye disease as well as an endocrinologist to manage any thyroid abnormalities. Smoking has been proven to worsen thyroid eye disease, and quitting is the most important thing patients can do to help improve their outcome. Patients with mild ophthalmopathy can often be evaluated periodically and managed to reduce ocular symptoms. Patients with moderate to severe disease may require intervention to reduce inflammation and preserve vision. Once the inflammatory phase has subsided, patients with eyelid abnormalities, double vision, or proptosis may benefit from surgical intervention to improve their function and appearance. Dr. Dal Canto is specialized in evaluating and monitoring disease progression and in medical and surgical management of eyelid and orbital abnormalities resulting from Graves ophthalmopathy.

Before and After Photographs

Patient # 1 return to top

Decompression surgery for Graves disease
BEFORE: 35 yo woman with Graves disease with proptosis, Left > Right.
AFTER: Four months after left orbital decompression and 3 months after right orbital decompression.
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery
Albert J. Dal Canto, M.D. -- Cosmetic & Reconstructive Eye Surgery