Thyroid Eye Disease Patients Face More Than Just Vision Problems
Research recently completed at Shiley’s unique Thyroid Eye Center established that the disfigurement associated thyroid eye diseases causes serious mood disturbance.
The Center utilizes the skills of four Shiley doctors with different ophthalmic subspecialties to correct the problems linked to Thyroid Eye Disease, also known as Graves disease. Ophthalmologists David Granet, M.D. (Eye-alignment), Don Kikkawa, M.D. (Eyelid and Orbital Surgery) and Bobby Korn, M.D., Ph.D. (Eyelid and Orbital Surgery), and Leah Levi, M.D. (Neuro-ophthalmology),
The study, "Psychological Disturbance in Graves' Ophthalmopathy,” published in the April 2005 issue of Archives of Ophthalmology, compared the mood of 24 mild cases with that of 24 moderate to severe cases, rating their mood based on levels of tension, depression, confusion, fatigue, and anger. The researchers determined the disfigurement experienced by those with the more severe cases significantly affected the patients’ day to day lives and dispositions. The disturbance of mood was further compounded by the public's often negative reaction to their appearance.
The results were not surprising to the Shiley team, including Dr. Levi who commented, "It's important that doctors begin to look past the visible symptoms and learn how to treat every aspect of a patient's disease when trying to plan a course of treatment.”
In evaluating the data, the researchers propose that the psychological repercussions of Thyroid Eye Disease need to be evaluated along with the physical effects. The authors also believe the level of the patient's emotional distress could significantly influence the joint patient-doctor decision about proper treatment, including timing of surgery. However, all those involved with the study agree that further research is needed to fully understand the connection between mood disturbances and Thyroid Eye Disease, and whether these patients can benefit from psychological intervention.
Thyroid eye disease is associated with hyperthyroidism, the over-activity of the thyroid gland resulting in an enlarged thyroid and many bodily changes, including changes of the eyes. Early eye symptoms include dryness, redness, itching, and swelling of the lids. In the more severe cases, symptoms advance to eyes bulging, loose enlarged eye muscles, and droopy retracted eyelids - stretched from the eyes protruding.
Fortunately, properly performed surgery can restore these patients’ appearance. However, correcting the disfigurements may require years of multiple operations, which can include orbital decompressions, realignment of the eye muscles, and reconstruction of the upper and lower eyelids. Once completed most patients are exceedingly pleased with their results. The results of this study may support a lowering of the threshold for performing reconstructive surgery. Further study is indicated to fully understand the psychological impact of this potentially devastating disorder.