Endocrine Abstracts

Thyroid ophthalmopathy can be, in moderate to severe cases, very disfiguring and thereby soul destroying. Even with excellent family support it is difficult to accept such changes in appearance. In the severe acute phase, management is usually non-surgical with medication and/or fractionated orbital radiotherapy. Rarely, orbital decompression is required to save failing sight resulting from optic nerve compression. This surgical procedure is nowadays more commonly performed to allow extra space in the orbit for the proptosed globes to move back to a more usual position, and is undertaken once the acute phase is long over. Diplopia, either previously present or as a result of decompression, can be surgically corrected by realignment of the affected external ocular muscles. Lid surgery is only embarked upon once orbital volume and ocular movement problems have been addressed, or if these features are not an issue. It is the final surgical stage in what can amount to a long-haul of several years of operations in the attempt to rehabilitate patients and restore their confidence. Surgical examples are presented.