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Eye diseases

Thyroid-associated orbitopathy

orbitopatia tiroidea
It is the most common disease affecting the eye orbit.
Tobacco increases the risk of suffering from it.
It can compromise vision in 5% of cases.

What is thyroid orbitopathy?

Thyroid orbitopathy is an eye disease of autoimmune origin, i.e. the body’s defences (antibodies) attack its own cells by mistakenly identifying them as invading agents. In this case, the antibodies are directed against the thyroid gland, making it more active than usual, which causes inflammation of the tissues of the eye orbit (eyelids, fat, extraocular muscles …) and the other soft tissues surrounding the eye.

We can differentiate between an active stage of the disease, in which the symptoms are more evident and severe due to the existence of a high inflammatory activity, and an inactive stage, in which the markers of thyroid orbitopathy may still be present, but not as virulently.

This disease is usually associated with “bulging eyes” or exophthalmos and alterations in the eyelids, such as eyelid retraction, as well as swelling and the appearance or increase of fat bags. Improper closing of the eyelids and increased exposure of the eye surface can cause eye discomfort and irritation.

If you have thyroid orbitopathy, it is also common for you to experience poor vision, when the cornea or the optic nerve is affected, as well as double vision due to the impact on the muscles responsible for eye movement and position. On the other hand, eye pain is a symptom that often occurs in the active stage of the disease as an effect of inflammation

Generally, thyroid orbitopathy occurs in people with alterations of the thyroid gland, almost always hyperthyroidism, although we do not always find this relationship between one disease and another.

It is known to be a problem that mainly affects middle-aged women. If you smoke, have received treatments that have irradiated your thyroid gland or have suffered from other autoimmune diseases, the risk of developing thyroid orbitopathy is also higher.

Treatment will depend on the stage of the disease:

  • Treatment of thyroid orbitopathy in the active stage: We usually prescribe steroids to control inflammatory activity and immunosuppressants to modulate the abnormal immune response.
  • Treatment of thyroid orbitopathy in the inactive stage: This is surgical, and we perform it when the inflammatory component has disappeared, no improvement is expected with medication and the sequelae are permanent.

Surgery for thyroid orbitopathy aims to repair tissues to improve the eye’s functionality, as well as ocular and facial aesthetics. These are different types of surgeries, depending on the sequelae that need to be addressed, whereas at the Miranza centres, we have specialists in each of them, who work together and in a coordinated manner to offer you the best results.