Thank you for your question.
You submitted several photos with your question.
You’re stating in your question that for the past several months that you noticed that
your one eye is looking smaller than the other eye and that you are having pain in the left
eye.
And so naturally you’re expressing concern about this situation and you want to get some
guidance.
Well, I can share with you my initial impressions and the first things I think about when I
hear a history like this.
This is of course without more details of your history as well as a physical exam but
we can certainly, hopefully help you get on the right path.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And what you are describing is familiar for a condition that may not be applied to you
but is important to at least seek attention to evaluate if this is the cause and that
condition is called thyroid related immune orbitopathy or thyroid eye disease.
And without making any type of assumption or conclusion, I can just share with you what
this condition describes.
Generally speaking, one of the early signs is noticing asymmetry between the two eyes.
In other words, one eye looking bigger than the other.
What is the underlying issue has to do with the immune system issue where the body creates
these antibodies that affect the eyes as well as affect the thyroid.
And so the appearance of patients who have thyroid eye disease or thyroid related immune
orbitopathy can be pretty significant.
Their eyes can bulge.
They can have retraction.
And in my practice, I have routinely helped patients surgically with restoring their appearance
but I don’t do that surgery until this first evaluation is done.
And so what I would advise is you need to see your medical doctor about this and maybe
get some thyroid testing done.
An ophthalmologist to evaluate your vision, to evaluate your eye pressures and you may
need some imaging studies to look at what’s going on behind your eyes.
Thyroid related eye disease affects the fat and muscles behind the eyes and can be managed
initially through appropriate treatments such as the use of oral steroids, IV steroids,
radiation, other options.
But without getting ahead of ourselves, just to give you an understanding, there are basically,
if this were the case, two phases of thyroid eye disease.
One is called the inflammatory phase and during that phase, there are changes that occur that
are variable.
And the eye muscles can enlarge and fat behind can increase.
The eyes can bulge forward.
They can get even misaligned.
And then there’s the fibrotic stage and that’s the resting stage or the resolution
of all this inflammation.
And this occurs typically over the course of a couple of years.
So that being said, it is appropriate not to just dismiss this.
Sometimes your symptoms can be something related to your sinuses and you may be just noticing
a natural asymmetry between your eyes.
So it doesn’t mean that you definitely have thyroid eye disease.
But when you use that type of language to someone with eye surgery or ophthalmology
background, then for a specialist like myself, this basically triggers a series of things
I would want information about so that you can be appropriately managed.
So again, learn about thyroid eye disease.
First seek the doctors before you assume that you have this and get properly evaluated and
make sure these evaluations are also followed up in order to get a proper diagnosis and
proper management.
So I hope that was helpful, I wish you the best of luck and thank you for your question.