Common Eye Protrusion in Thyroid Disease Patients, Treatment Effect Enhanced with 'Navigation Orbital Decompression Surgery'

Inducing Eye Retraction with Precise Surgery
Also Reduces Complication Occurrence

Professor Lee Jung-kyu of the Department of Ophthalmology at Chung-Ang University Hospital is performing orbital decompression surgery using computer navigation.
[Photo by Chung-Ang University Hospital]

[Asia Economy Reporter Lee Gwan-ju] Among patients with thyroid disease, some experience discomfort such as their eyes becoming enlarged like goldfish, protruding forward, swelling, or developing inflammation. This condition is called 'thyroid eye disease,' which refers to various eye changes and ophthalmic disorders associated with thyroid dysfunction.

As the eyeball protrudes, initial symptoms include eyelid swelling or asymmetric upper eyelid retraction that makes the eyes appear startled. As the disease progresses, further protrusion of the eyeball occurs, accompanied by conjunctival edema, dry eye syndrome, exposure keratitis, and increased intraocular pressure. It is known that more than 20% of patients with hyperthyroidism have exophthalmos. These symptoms can also appear when thyroid function is normal or in cases of hypothyroidism.

The cause of exophthalmos is swelling or inflammation of the muscles and other tissues around the eyes due to an abnormal immune response. Antibodies, which should attack external bacteria, show an autoimmune tendency by attacking the muscles and fat tissues around the eyes, causing abnormal reactions. When diagnosed with hyperthyroidism, changes in the eyes may occur very gradually, and even if protrusion is present, the patient may not notice it. Additionally, many cases exist where patients are unaware of decreased vision in one eye, so it is essential to visit an ophthalmologist to check vision, intraocular pressure, exophthalmos index, and ocular motility disorders.

Professor Lee Jeong-gyu of the Department of Ophthalmology at Chung-Ang University Hospital stated, "The exact cause of thyroid eye disease is not yet known, but in cases of hyperthyroidism, excessive secretion of thyroid hormones causes antibodies that attack external bacteria to attack the patient's own eye cells, leading to the condition." He added, "Not all patients with thyroid disease and hyperthyroidism develop thyroid eye disease, and it can also occur when thyroid hormone levels are normal or in hypothyroidism."

When diagnosed with thyroid eye disease, dry eye syndrome often accompanies it, so symptoms should be alleviated using artificial tear eye drops. For severe acute inflammation with pain, conjunctival congestion, and eyelid swelling, high-dose steroids or radiation therapy may be helpful. However, if exophthalmos is severe, the cornea is damaged, or the optic nerve is compressed causing vision loss or risk of blindness, an 'orbital decompression surgery' that partially removes the orbital bone must be performed.

Orbital decompression surgery involves removing part of the orbital bone, the space where the eyeball sits, to enlarge the bony cavity or removing orbital fat tissue, which causes the eyeball protrusion. It is the most effective treatment for thyroid eye disease. Recently, computer navigation-assisted orbital decompression surgery has been introduced, enabling more precise surgery that reduces the risk of complications and provides more effective treatment.

Professor Lee said, "Using computer navigation, the location of the orbital bone or soft tissue to be removed during surgery can be accurately identified in real-time by comparing it with preoperative CT images, allowing smaller incisions, faster surgery, and reduced risk of complications." He added, "Results from orbital decompression surgeries using computer navigation confirmed that removing significantly more orbital bone improved the effect of reducing exophthalmos."

This content was produced with the assistance of AI translation services.