The eyelids in Thyroid Orbitopathy

Eyelid involvement in Thyroid Orbitopathy (TO) is very common. In the early stages of inflammatory TO, edema and injection of the eyelids may warn the physician of the development of severe TO and the need for anti-inflammatory treatment. Lid retraction is the commonest sign of TO and in many cases is the presenting symptom of Graves' disease and its orbital involvement. In the past several decades many surgical approaches have been suggested to deal with upper and lower lid retraction in the easiest, most predictable and reproducible manner. The different manifestations of TO in the eyelids are summarized and some of the common surgical approaches of correcting lid retraction practiced today are presented.