Also known as Graves’ eye disease or Graves’ ophthalmopathy, thyroid eye disease is characterized by thyroid overactivity or thyroid underactivity. Graves’ disease is an autoimmune condition, wherein the body’s immune system attacks the thyroid gland, forcing it to produce more than required thyroid hormone.
One in four people detected with Graves’ disease is likely to get thyroid eye disease. The overactivity of the thyroid causes inflammation in the tissues surrounding the eye. The eye and eyelids become swollen and red because of the intraorbital fat pushing the eyeball forward leading to eyelid retraction. This gives a starry and bulged look resulting in a disfigured facial appearance. This disease can also cause double vision and optic nerve compression.
In some cases, the disease also causes ulcers on the front part of the eyes when the eyelids do not close completely. Botox has been known to be used as a treatment for thyroid eye disease. Given below are some important things to know while opting for Botox to treat thyroid eye disease.
- Is botulinum toxin type A injection popular in treating thyroid eye disease?
Eyelid retraction in patients suffering from thyroid eye disease causes a lot of discomfort. Several case studies have indicated that Botox treatment for this medical condition has been beneficial and it is an excellent temporary relief therapy. However, in-depth research and long term follow up studies are required to establish the superiority of this treatment over others.
- What is the procedure of Botox therapy for thyroid eye disease?
Botulinum toxin type A is injected into the muscle of the eyelid. The dose of the injection depends on the degree of retraction. In cases of bilateral retraction, each eye is treated separately with a time gap of at least one week as there is a risk of inducing complete ptosis.
- What are the expected outcomes of Botox treatment?
Botox treatment has shown highly satisfactory results in patients with thyroid eye disease. In most of the cases, the eyelids lower within a week after the treatment. The following things should be kept in mind after Botox has been used to treat thyroid eye disease:
- There is an expected improvement in the appearance and the symptoms.
- The effect of the treatment lasts for a maximum period of 20 weeks. After this period the residual effect of the first injection will be absent in most of the cases.
- With the same dose of injection, the treatment has a varying degree of outcome in different individuals. The degree of lowering of the eyelid may not be the same among all individuals who undergo this treatment.
- Botox treatment can give only temporary relief. Hence, follow up treatment or re-treatment is required.
- Botox treatment does not give a basis to predict the time interval needed for re-treatment.
- This treatment has an inherent risk of transient diplopia.
- What is the follow up required after the first Botox injection?
Ophthalmologists may decide on the sequence of treatments for thyroid eye disease after assessing the patients. This will vary with individual patients based on certain criteria that may include the condition and the degree of impairment, and the response to Botox treatment. Re-treatment of Botox injection may be given in certain cases. Botox treatment is often given before impending eye surgery to lower the eyelids. As this disease is normally caused by abnormal thyroid function, the key to treatment is to achieve a euthyroid state in patients.