Who needs treatment?
All patients of thyroid eye disease do not require treatment.
For mild cases of TED with no swelling or mild bulging of the eyes, simple lubricating eye drops can keep them happy.
In the active phase, your eye plastic surgeon will decide if you need treatment. The commonest treatment that may be required is steroids ( injections or tablets). Since steroids can have side-effects, the decision to treat has to be taken judiciously.
In the inactive phase, surgical treatment is usually done. Surgical correction is done in stages, and we universally follow this sequence:
1) Prominence of the eye is first corrected, by orbital decompression surgery. 2) Double vision if any, is addressed next with squint surgery. 3) Correction of eyelid abnormality comes next 4) Finally, cosmetic concerns if any, are treated with non-surgical methods.
Each of these 4 steps require 2-4 months of wait period, so it is normal for your treatment to extend over 9-12 months. Every patient does not require all 4 steps. The best way to decide whether you need treatment or not is by discussing it with your eye-plastic surgeon (oculoplastic surgeon).
What if I do not take any treatment?
If the TED is severe (nerve compression), treatment is required, and avoiding it may cause vision loss. In moderate cases, whether treatment is required or not is decided by the ophthalmologist. In mild cases, you can safely avoid any treatment. But, getting corrective procedures done will certainly improve your appearance, and self-esteem.
Majority of patients with thyroid eye disease undergo corrective procedures to improve their appearance. Choosing a well-trained,safe and experienced eye plastic surgeon is of paramount importance!