People with thyroid eye disease can experience many troubling complications, including protruding eyes, eye pressure or pain, and eyelids that are swollen or don’t close completely. Left untreated, a person with this disease could suffer permanent vision loss.
To prevent that from happening, some people with thyroid eye disease have orbital decompression surgery to improve their vision and allow their eyes to return to a more normal position, followed by surgery to treat double vision due to strabismus (misaligned eyes) and then eyelid surgery.
It takes a team of doctors who specialize in these procedures to manage and treat people with thyroid eye disease, also known as Graves’ ophthalmopathy. To help simplify these patients’ lives, the University of Minnesota recently opened its Center for Thyroid Eye Disease, housed in the Department of Ophthalmology. This center makes it possible for people with thyroid eye disease to be seen by an entire team of specialists in one visit: a neuro-ophthalmologist, an adult strabismus specialist, an orbital and oculoplastic surgeon, and an orthoptist.
The team provides innovative multidisciplinary care and offers the latest diagnostic and treatment options for people with thyroid eye disease. These specialists are also researchers working to advance medical understanding of thyroid eye disease and develop new ways to treat it.
The center’s codirectors are Erick Bothun, M.D., assistant professor of pediatric ophthalmology and adult strabismus; Andrew Harrison, M.D., assistant professor of ophthalmic plastic and reconstructive surgery; and Michael Lee, M.D., associate professor of neuro-ophthalmology.
“The idea behind the center is to streamline care for the patient,” Lee explains. “Instead of the patient being seen by each of us separately, which requires at least three visits, we examine the patient as a team. This approach enables us to give thyroid eye disease patients the best possible care and, in the long run, it will also save both time and money.”
The team approach “is a real change from a care perspective,” Bothun says. “With better communication and collaboration comes better care. Because we are together while examining a patient, we can hear what our colleagues are thinking and make treatment decisions collectively.”
The majority of thyroid eye disease patients need to see more than one specialist. “Especially in complex cases, it’s nice to see these patients together from the start,” Harrison says. “It can take a long time for thyroid eye disease to run its course. It’s a complex disease and complicated to treat, but I enjoy the challenge of taking care of these patients, doing both orbital decompression and eyelid surgery. It can be a disturbing disease socially, from a cosmetic standpoint. That’s just one of the things we’re able to fix with surgery.”
Erika Shane was fatigued and felt sensitive to cold when she was diagnosed with Graves’ disease in her late teens, when she lived in Texas. After she moved to Minnesota, her thyroid eye disease started to emerge, and over time her eyes began to bulge. Then she sought help from the team of ophthalmologists at the University.
“At first I said I never wanted to have eye surgery,” says Shane, who is now a 25-year-old animal sciences graduate student at the University. “But as I got older and noticed the bulging more, I reconsidered.”
When Shane first met with Harrison, he explained the risks and benefits of orbital decompression surgery. “I felt really comfortable with him,” she says. “He explained that he has done tons of these surgeries. The surgery went well, although I developed double vision afterward, which is one of the risks.”
To fix that problem, Bothun performed another surgery to correct the double vision. Now Shane is awaiting eyelid surgery to make both eyelids symmetrical, as the previous procedures she has had left one eyelid wider than the other.
Shane says she appreciates the team approach to her care at the new Center for Thyroid Eye Disease.
“I can see all three doctors in one visit,” she says. “I don’t need to go anywhere else for help because all three of them are top in their field. I know I’m getting the very best care.”