Management of eyelid retraction related to thyroid eye disease

Tammy H Osaki; Lucas G Monteiro; Midori H Osaki

doi:10.4103/tjo.tjo_57_21

Management of eyelid retraction related to thyroid eye disease

Taiwan J Ophthalmol. 2022 Feb 14;12(1):12-21. doi: 10.4103/tjo.tjo_57_21. eCollection 2022 Jan-Mar.

Authors

Tammy H Osaki^{1

2

3}, Lucas G Monteiro³, Midori H Osaki^{1

2}

Affiliations

¹ Department of Ophthalmology and Visual Sciences, Division of Ophthalmic Plastic and Reconstructive Surgery, Paulista School of Medicine, Federal University of São Paulo EPM/UNIFESP, São Paulo, Brazil.
² Eye & Eyelid Experts, Division of Ophthalmic Plastic Surgery, São Paulo, Brazil.
³ Department of Ophthalmology, Division of Ophthalmic Plastic and Reconstructive Surgery, University of Santo Amaro/ UNISA, São Paulo, Brazil.

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.

Keywords: Biological agents; blepharotomy; botulinum toxin; eyelid retraction; hyaluronic acid; levator recession; spacer grafts; thyroid eye disease; triamcinolone.

Publication types

Review