ELIZABETH BRADLEY: I'm Dr. Elizabeth Bradley. I'm one of the orbital surgeons in Mayo's Thyroid Eye Disease Clinic. Mayo has really been at the forefront of scientific investigation in thyroid eye disease and thyroid disease in general since the time of the Mayo brothers. Some of the landmark studies in thyroid eye disease natural history and epidemiology were performed here at Mayo Clinic. Those were followed by early studies looking rigorously at the effect of orbital radiation for thyroid eye disease and up to the present day, where we're involved in looking at some of the newer therapeutic agents.
LILLY WAGNER: During their visit in the Thyroid Eye Disease Clinic, patients are evaluated by an oculoplastic and orbital specialist, a strabismus surgeon, an endocrinologist, and an ENT surgeon. The goal of the visit is for patients to gain an excellent understanding of their disease process, to get an idea of what their course may be over the next months or even years, and to learn about different treatment options that are available to them.
MARIUS STAN: Hello, I'm Marius Stan. I'm an endocrinologist here at Mayo Clinic. Many of these patients, as you might know, have an overactive thyroid, a condition called Graves disease. But that is not always the case. Some patients have normal thyroid levels or even low thyroid levels. Normalizing thyroid hormone levels is very important for the overall health, and I'm thinking heart, bones, and other organs. But it is also important for the eye disease itself.
In addition, some of the medications that we use for thyroid eye disease can affect other endocrine functions like glucose control. And thus, these medications are best managed through this multidisciplinary clinic.
JANALEE STOKKEN: If patients develop bulging of the eyes due to swelling of the muscles and fat in the eye socket, they may need orbital decompression surgery. We can achieve removal of the orbital wall medially and the floor with endoscopic sinus surgery through the nose and sinuses. This minimally invasive approach avoids additional external incisions and bruising and can be done alone or in combination with a decompression of the lateral orbital wall through a small eyelid incision. The use of intraoperative navigation can make this surgery even more effective.
ERICK BOTHUN: My name is Erick Bothun. I'm a strabismus surgeon at the Mayo Clinic. Strabismus means the eyes are not aligned. Swelling of eye muscles from thyroid eye disease can lead to double vision or diplopia. In many patients with thyroid eye disease, double vision and loss of depth perception greatly affects visual functioning and activities of daily living, such as driving.
If double vision does not resolve once the inflammation of the muscles subsides, patients may be candidates for eye muscle surgery to restore the alignment of the eyes and improve or eliminate double vision.
ANDREA TOOLEY: I'm Andrea Tooley. I'm an oculoplastic and orbital surgeon here at Mayo Clinic. Thyroid eye disease has a profound impact on the appearance and your quality of life. It's a very difficult condition to treat for, both, patients and providers, and there's no real one size fits all. It requires a team-based approach and customized care for you.
That's why at Mayo Clinic you'll see up to four different providers to provide a clinical plan of care for your specific thyroid eye disease. That plan will be discussed with you in the afternoon of your visit. You'll get a full, rounded, comprehensive plan so that you feel confident in the treatment of your thyroid eye disease.