Management of Eyelid Retraction Related to Thyroid Eye Disease

Overview

Journal Taiwan J Ophthalmol

Specialty Ophthalmology

Date 2022 Apr 11

PMID 35399960

Authors

Tammy H Osaki

Lucas G Monteiro

Midori H Osaki

Affiliations

Soon will be listed here.

Abstract

Eyelid retraction related to thyroid eye disease (TED) is a challenging condition. It is one of the main clinical signs and a major diagnostic criterion in TED. This condition may threaten vision due to exposure keratopathy, in addition to its esthetic alterations, which may lead to psychosocial implications and affect the patient's quality of life. Although it is more commonly observed in the upper eyelid, it may be present on both the upper and lower lids. Numerous surgical and nonsurgical treatment modalities have been described and will be reviewed in this article. Management should be based on an individual patient assessment, taking into consideration the disease stage, severity, and clinician experience.

Citing Articles

Eyeball descending identification using MRI-based spatial coordinates in thyroid-associated orbitopathy patients with unilateral upper eyelid retraction.

Gou X, Wang Y, Li T, Zhou L, Lian J, Zhang X Quant Imaging Med Surg. 2025; 15(2):1287-1296.

PMID: 39995720 PMC: 11847195. DOI: 10.21037/qims-24-1659.

Eyelid Reconstruction.

Gillipelli S, Quirarte D, Owens W, Parham M, Jiang A, Williams K Semin Plast Surg. 2024; 38(4):279-289.

PMID: 39697411 PMC: 11651827. DOI: 10.1055/s-0044-1795099.

A Comprehensive Review of Thyroid Eye Disease Pathogenesis: From Immune Dysregulations to Novel Diagnostic and Therapeutic Approaches.

Kulbay M, Tanya S, Tuli N, Dahoud J, Dahoud A, Alsaleh F Int J Mol Sci. 2024; 25(21).

PMID: 39519180 PMC: 11546489. DOI: 10.3390/ijms252111628.

Alpha-1 antagonist treatment for eyelid retraction in patients with thyroid eye disease-a prospective pilot study.

Arnon R, Goldberg H, Ben-Simon G, Priel A, Zloto O, Landau-Prat D Eye (Lond). 2024; 39(1):175-178.

PMID: 39428445 PMC: 11733210. DOI: 10.1038/s41433-024-03403-8.

Extraocular Muscle Enlargement in Thyroid Eye Disease Using Volumetric Analysis.

Park K, Li J, Wen J, Li S, Lee J, Danesh K Cureus. 2024; 16(7):e63843.

PMID: 39105029 PMC: 11298761. DOI: 10.7759/cureus.63843.

References

Mancini R, Khadavi N, Goldberg R . Nonsurgical management of upper eyelid margin asymmetry using hyaluronic acid gel filler. Ophthalmic Plast Reconstr Surg. 2010; 27(1):1-3. DOI: 10.1097/IOP.0b013e3181c2a16d. View

Harrison A, McLoon L . Effect of hyperthyroidism on the orbicularis oculi muscle in rabbits. Ophthalmic Plast Reconstr Surg. 2002; 18(4):289-94. DOI: 10.1097/00002341-200207000-00011. View

Xu D, Liu Y, Xu H, Li H . Repeated triamcinolone acetonide injection in the treatment of upper-lid retraction in patients with thyroid-associated ophthalmopathy. Can J Ophthalmol. 2012; 47(1):34-41. DOI: 10.1016/j.jcjo.2011.12.005. View

Ebner R . Botulinum toxin type A in upper lid retraction of Graves' ophthalmopathy. J Clin Neuroophthalmol. 1993; 13(4):258-61. View

Copperman T, Idowu O, Kersten R, Vagefi M . Subcutaneous Tocilizumab for Thyroid Eye Disease: Simplified Dosing and Delivery. Ophthalmic Plast Reconstr Surg. 2019; 35(3):e64-e66. DOI: 10.1097/IOP.0000000000001346. View

Morgenstern K, Evanchan J, Foster J, Cahill K, Burns J, Holck D . Botulinum toxin type a for dysthyroid upper eyelid retraction. Ophthalmic Plast Reconstr Surg. 2004; 20(3):181-5. DOI: 10.1097/00002341-200405000-00001. View

Kim K, Woo Y, Jang S, Lee E, Yoon J . Correction of Lower Eyelid Retraction Using Acellular Human Dermis During Orbital Decompression. Ophthalmic Plast Reconstr Surg. 2016; 33(3):168-172. DOI: 10.1097/IOP.0000000000000683. View

Park E, Lewis K, Alghoul M . Comparison of Efficacy and Complications Among Various Spacer Grafts in the Treatment of Lower Eyelid Retraction: A Systematic Review. Aesthet Surg J. 2017; 37(7):743-754. DOI: 10.1093/asj/sjx003. View

Bartley G, Gorman C . Diagnostic criteria for Graves' ophthalmopathy. Am J Ophthalmol. 1995; 119(6):792-5. DOI: 10.1016/s0002-9394(14)72787-4. View

10.

Sullivan S, Dailey R . Graft contraction: a comparison of acellular dermis versus hard palate mucosa in lower eyelid surgery. Ophthalmic Plast Reconstr Surg. 2003; 19(1):14-24. DOI: 10.1097/01.IOP.0000040678.19893.F7. View

11.

Lee J, Lee H, Park M, Baek S . Subconjunctival injection of triamcinolone for the treatment of upper lid retraction associated with thyroid eye disease. J Craniofac Surg. 2012; 23(6):1755-8. DOI: 10.1097/SCS.0b013e3182646043. View

12.

RUNDLE F . Management of exophthalmos and related ocular changes in Graves' disease. Metabolism. 1957; 6(1):36-48. View

13.

Chalfin J, Putterman A . Müller's muscle excision and levator recession in retracted upper lid. Treatment of thyroid-related retraction. Arch Ophthalmol. 1979; 97(8):1487-91. DOI: 10.1001/archopht.1979.01020020149013. View

14.

Stan M, Salvi M . MANAGEMENT OF ENDOCRINE DISEASE: Rituximab therapy for Graves' orbitopathy - lessons from randomized control trials. Eur J Endocrinol. 2016; 176(2):R101-R109. DOI: 10.1530/EJE-16-0552. View

15.

RUNDLE F, Wilson C . Development and course of exophthalmos and ophthalmoplegia in Graves' disease with special reference to the effect of thyroidectomy. Clin Sci. 2010; 5(3-4):177-94. View

16.

Kersten R, Kulwin D, Levartovsky S, Tiradellis H, Tse D . Management of lower-lid retraction with hard-palate mucosa grafting. Arch Ophthalmol. 1990; 108(9):1339-43. DOI: 10.1001/archopht.1990.01070110155041. View

17.

Ben Simon G, Mansury A, Schwarcz R, Modjtahedi S, McCann J, Goldberg R . Transconjunctival Müller muscle recession with levator disinsertion for correction of eyelid retraction associated with thyroid-related orbitopathy. Am J Ophthalmol. 2005; 140(1):94-9. DOI: 10.1016/j.ajo.2005.02.034. View

18.

Joos Z, Sullivan T . Peri-levator palpebrae superioris triamcinolone injection for the treatment of thyroid eye disease-associated upper eyelid retraction. Clin Exp Ophthalmol. 2017; 45(6):651-652. DOI: 10.1111/ceo.12939. View

19.

Gurdal C, Sarac O, Genc I, Kirimlioglu H, Takmaz T, Can I . Ocular surface and dry eye in Graves' disease. Curr Eye Res. 2010; 36(1):8-13. DOI: 10.3109/02713683.2010.526285. View

20.

Shih M, Liao S, Lu H . A single transcutaneous injection with Botox for dysthyroid lid retraction. Eye (Lond). 2004; 18(5):466-9. DOI: 10.1038/sj.eye.6700690. View