Treatment of Orbital Diseases

We offer medical and surgical treatments for orbital diseases, including dysthyroid orbitopathy, or thyroid eye disease, and tearing (epiphora).

Dysthyroid orbitopathy, or thyroid eye disease, is an autoimmune disease process. The muscles of the eyes and fatty tissue around the eye swell, causing a bulging eyes, eyelid retraction, and possibly even vision impairment. Often, dysthyroid orbitopathy is associated with hyperthyroidism, a disease that occurs when the thyroid gland secretes excess hormones.

Diagnostic procedures include testing for hyperthyroidism, and a series of examinations performed by an ophthalmologist. To treat the swelling and inflammation, corticosteroids may be prescribed and thyroid function is normalized with the help of an endocrinologist. In cases which do not adequately respond to medications, surgical decompression of the orbital cavity may be performed. This allows the swollen tissue to prolapse or herniate into the sinuses, relieving pressure on the eye and optic nerve, and allowing the eye to sink back into its native position.

Tearing (epiphora) is characterized by overflow of tears. This occurs when tears are unable to drain into the nose through the nasolacrimal system. Tears are produced in the lacrimal gland in the outside corner of the eye, and cross the eye into the lacrimal sac, which directs the tears into the nose through the nasolacrimal duct. When there is obstruction of this duct, drainage of the tears cannot occur and they accumulate externally.

Nasal blockage could occur from a variety of causes, such as inflammation, infection, structural defects, trauma, or growths. Proper diagnosis requires thorough examination and testing by an ophthalmologist. In some cases, opening of the lacrimal sac is recommended, and can be performed in a minimally-invasive endoscopic outpatient procedure known as endoscopic dacryocystorhinostomy (DCR).