View 2019 Abstracts

Thyroid eye disease is a common condition encountered by ophthalmologists worldwide with limited treatments available during the active phase. Previous case reports have shown improvement in upper eyelid retraction with intra-orbital Triamcinolone however further research is needed.
Our aim was to document the effect of intra-orbital Triamcinolone on upper eyelid retraction in patients with active thyroid eye disease.

This is a case series in which 3 patients with active thyroid eye disease and upper eyelid retraction presented to our clinic from July 2018 to January 2019. As per previous case reports, 1mL of 40mg/mL Triamcinolone was injected intraorbitally around levator palpebrae superioris (LPS). Parameters measured were upper scleral show and upper margin reflex distance (MRD). Patients were followed up 2 weeks after the injection.

Two out of 3 patients had complete resolution of upper scleral show and improvement in upper MRD at the first follow up visit. One patient however had no improvement initially and so was given a second injection at 2 weeks. She later showed no upper scleral show and improvement in upper MRD 2 weeks after the second injection. This is highlighted in clinical photographs taken.

Intra-orbital Triamcinolone has been effective in reducing upper eyelid retraction in our patients with active thyroid eye disease. This is thought to be due to the targeted injection of steroid at LPS causing reduced inflammation and subsequent reduced retraction of muscle. In these cases, the use of systemic steroids and associated side effects were avoided. Additional research is needed however results from our case series have shown a positive effect.