Thyroid Eye Clinic - Shiley Eye Center

The UCSD Shiley Eye Center recently established a special clinic to treat Southern Californians with thyroid-related eye disease. This clinic uniquely offers coordinated, multidisciplinary care by subspecialists David B. Granet, M.D., (Eye Alignment Disorders); Don O. Kikkawa, M.D. (Orbital and Eyelid Surgery); and Leah Levi, M.D. (Neuro-ophthalmology). Collectively, the team provides each patient individualized treatment, helping people with severe functional and cosmetic abnormalities that can result from this disease.

Early eye symptoms, which may include dryness, redness, itching, and swelling of the lids, are usually mild. These mild symptoms can often be successfully treated with frequent applications of lubricating eye drops and eye covers at night.

In many cases, protrusion of the eye, producing disfigurement and eyelid retraction may occur and progress to a point where the eyes do not close completely. Once inflamed, the eye disease may remain active from several months to as long as three years. However, the condition generally subsides over a period of time and, occasionally, improves completely.

Approximately six months after the condition has stabilized, corrective surgery can be considered. Depending on how thyroid eye disease has affected the patient's eyes, surgery options include orbital decompression to place the eye back in its socket, alleviation of retracted eyelids, loosening of the eyelid muscles, as well as removal of scar tissue, excessive fatty tissue and skin.

A small number of patients will develop double vision (diplopia), which is the result of scarring and inflammation of the eye movement muscles. In these cases, medical treatment, radiotherapy, and/or muscle surgery may be required to restore vision. In addition, Shiley Eye Center is one of the few centers nationally that offers state-of-the-art Botox Therapy for these eye alignment disorders.

The expertise of Shiley specialists provides the best coordinated care for patients suffering from thyroid-eye disease. To make an appointment with the Thyroid Eye Clinic call (858) 534-6290.

 

Shiley's Unique Thyroid Eye Center
From the Shiley Eye Center Viewpoint

The UCSD Shiley Eye Center’s Thyroid Eye Clinic was established in 1997 as the first of its kind in the United States. Since then, almost 500 patients have been treated for thyroid-related eye disease at Shiley. Thyroid-related eye disease is a potentially blinding and disfiguring disorder. The clinic combines the unique talents of three specialists at Shiley, David B. Granet, M.D., (Eye Alignment Disorders); Don O. Kikkawa, M.D. (Orbital and Eyelid Surgery); and Leah Levi, M.D. (Neuro-ophthalmology), to provide the latest therapeutic advances in treatment, many of which were developed at the clinic. Thyroid-related eye disease can affect all aspects of the eye; because of this, all three specialists are present at the patient’s visit and together they discuss the situation with the patient and develop an individualized management plan. This is what makes the UCSD Thyroid Eye Clinic so unique.

This year, the team published one of the first studies to report on the psychological disturbance of the disorder. The study was published in the April 2005 issue of Archives of Ophthalmology. Drs. Granet, Kikkawa, and Levi showed that patients with moderate to severe thyroid-related eye disease have a marked propensity for significant depression, anxiety and mood alteration. A patient’s susceptibility to these psychological disorders correlates highly with the disfigurement caused by the disease. The doctors concluded that the psychological burden must be considered in every evaluation and that the level of disfigurement may impact the surgical threshold for treatment.

Thyroid-related eye disease is the result of an immune system attack that targets the soft tissues of the eyes. Although there is often a similar autoimmune attack on the thyroid gland itself, producing abnormalities in the levels of thyroid hormones, the thyroid gland itself does not actually cause the eyes to swell and protrude.

Thus, the term thyroid-related eye disease can sometimes be confusing to both patients and doctors.

Many disillusioned patients travel from afar to Shiley’s Thyroid Eye Clinic after having been told by their previous doctor that nothing can be done for their thyroid- related eye problems. The Thyroid Eye Clinic at the Shiley Eye Center has been an exceptional resource to frustrated patients and physicians in Southern California and beyond.