Management of Graves' upper eyelid retraction (GUER): A review

Graves' disease, a common autoimmune disorder, characteristically presents with upper eyelid retraction, causing significant functional and cosmetic concerns for affected individuals. The management of Graves' upper eyelid retraction has evolved significantly over recent years, with various surgical and non-surgical interventions. An ideal procedure is predictable and easily repeatable. This review provides a comprehensive overview of the contemporary approaches to managing Graves' upper eyelid retraction, encompassing both traditional and emerging techniques. It critically evaluates the surgical options for correcting Graves' upper eyelid retraction to achieve the desired eyelid contour, eyelid crease, tarsal platform show, and brow fat span. Their comparative effectiveness is meticulously explored, offering clinicians valuable insights into treatment selection. Moreover, this review also underscores combined orbital decompression with levator recession. Additionally, advancements in non-invasive modalities, including botulinum toxin, triamcinolone acetate injections, and hyaluronic acid fillers are discussed in detail. This review aims to facilitate informed decision-making and improve the overall outcomes for individuals affected by Graves' disease-associated upper eyelid retraction.