HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Does Eyes Look Large And Bulging After Laser Surgery?

Posted on Wed, 3 Sep 2014

Question: I have had Graves disease for about 35 years and had an orbital decompresion about 30 years ago. My right eye did not heal properly but after a couple follow-up surgeries it was OK, though it always looked a bit larger than my left eye after the surgeries. Just recently I had to have a laser treatment in my right eye due to a small tear in the retina. Since then, I feel that my right eye looks even larger & more bulging than it did prior to the treatment. Could the laser treatment have caused this? I've been on synthroid for all this time, and I do see an endocrinologist about twice a year to check my thyroid levels. I also see a glaucoma specialist about three times a year. Which dr. should be able to give me more info. about this? Thanks much, XXXX

Answered by Dr. Dadapeer K (11 minutes later)

Brief Answer:
It is because of Grave's disease.

Detailed Answer:
Hello
Welcome to Health care magic.

I am Dr. DADAPEER K, an ophthalmologist and I answer health problems related to eye. If you can upload a photo of the eye and the reports, I will be better able to help.

I reviewed your history. The bulging of the eye called as exophthalmos is characteristically caused by Grave's eye disease/ Thyroid ophthalmopathy.

The laser treatment of the retinal tear is not related to larger appearance of the eye/ exophthalmos.
You need to consult your endocrinologist since the exophthalmos is because of Grave's disease.

The treatment is regular monitoring with treatment of the thyroid condition. If the exophthalmos is progressive and causing pressure over optic nerve or causing some other complications then treatment is required in the form of steroids or immunosuppressants or by orbital decompression surgery.

Hope the information is helpful to you.

Thank you
With regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dadapeer K (25 hours later)

Thank you for your response. I'm still not clear on one thing. Are you saying that it's *possible* that my right eye is bulging a bit more due to my thyroid levels now having gotten out of sync? Or could the levels still be OK, but the eye is for unknown reasons bulging more again? Could the eye possibly still be swollen due to the laser treatment, in which case it will go back to normal at some point? Also, I forgot to mention in my previous question that my opthalmologist has been trying several different glaucoma drops, because I seem to have an allergic reaction to many of them. I tolerate the Alphagan P pretty well, and in addition have started the Latanoprost at night just a couple of weeks ago. Sometimes I have quite a bit of burning, especially in the enlarged eye, during the night. Could this also be contributing to my eye size? Thanks for your responses. (By the way, I'm sending this message from a different email address. My regular address is: YYYY@YYYY .)

Answered by Dr. Dadapeer K (33 minutes later)

Brief Answer:
It is probably because of thyroid eye disease.

Detailed Answer:
Hello
Thank you for the follow up question.

Laser treatment and anti-glaucoma medications will not lead to enlargement in the size of the eye. Burning sensation is caused by the anti-glaucoma drugs. Burning sensation will not contribute to enlargement in the size of the eye.

The causes for enlargement in the size of the eye are the causes for proptosis in the form of enlargement of any of the contents of the orbit as in enlargement of the extraocular muscles, increased size of the eye ball which occurs in pathological myopia....
However the commonest cause is thyroid disease. Irrespective of the control of the thyroid hormone level, this enlargement can occur as it is basically depends on the immune response and Grave's disease is autoimmune in nature.

Hence my first diagnosis will still be Graves eye disease and it is probably responsible for your bulging eye size and it is called as exophthalmos.

If the problem is progressive I would like to suggest you to undergo CT scan of the orbit to look for other causes or for confirming Grave's disease.

Hope the information is helpful to you.

Thank you
With regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar