Houston specialist offers innovative solutions for thyroid eye disease

A local woman is on a mission to repair the aftermath of an autoimmune condition called thyroid eye disease. Isamar Monrroy found a specialist in Houston who specializes in this, and she's hopeful the doctor can help her feel confident again. Now, she's sharing her experience to spread awareness about an under-diagnosed condition.

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Isamar is treated at Houston Oculofacial Plastic Surgery.

"I feel like my self-esteem is going to get better. I take normal pictures without filters; you know how social media is right now," states Isamar. She explains how she has suffered with one eye that bulges for the past six years. This is after being diagnosed with thyroid eye disease at 26 years old. It used just to be known as Graves' Disease. "It was actually right after I gave birth. I had a follow-up appointment with an ophthalmologist, and he was the first to notice it," says Isamar.

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Oculofacial Plastic Surgeon Dr. Mirwat Sami isn't surprised by the timing! She says hormonal changes like pregnancy or changing birth control can cause thyroid eye disease.

"As a result of that inflammation, there's swelling, scar tissue that develops as congestion. And then because the eye socket is very tight, sort of like a cone, and the eyeball sits in it like a scoop of ice cream, when everything behind the eye gets very swollen and inflamed, the eye starts getting pushed out. So, you'll see people with this condition that will have eyes that are almost bulging out," describes Dr. Sami.

She says the autoimmune condition can also cause dry eyes, vision problems, and even double vision. Here are some other patients she has helped reduce their problems with the same condition with surgery. It's beyond just looks! A procedure can reduce pressure on the optic nerve, which can result in permanent vision loss.

"Think of your thyroid hormone and that whole hormonal sort of equilibrium as the thermostat of your body. It sets the pace for your pulse, your temperature, how hot or cold you feel, how sleepy or attentive you are, and even your bowel habits. So, it really impacts people on such an integral, visceral level. And then to have these changes showing up in your face can be quite devastating," says Dr. Sami.

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Isamar also underwent gastric bypass surgery to lose weight and take pressure off her entire body from the extra weight.

"It helped in so many ways! Physically and mentally, my self-esteem went higher; it wasn't low, but I felt better. Being a mom of two boys, I have the energy for them," says a smiling Isamar.

Now, Dr. Sami is closely monitoring Isamar during her lifestyle changes. When her weight stabilizes, she'll be ready for surgery, probably in January. Isabel is more than ready for it.


"Now that I had my second baby, I haven't been able to take a family picture because it bothers me how my eyes look," exclaims Isamar. "What we want is for her eyelid to not be so elevated and retracted and to lower it. The shape of her almond eyes is so beautiful! For whatever reason, the inflammation is centered around the muscle, lifting the eyelid muscle, and it's causing retraction and upward pull and not allowing the lid to relax. With surgery, we'll be able to lower the position, so it looks more natural and rested," states Dr. Sami. This team is ready for the balancing act to begin soon!

Dr. Sami says treatments have definitely come a long way in treating thyroid eye disease. New medications can sometimes reverse the problem before surgery is necessary but must be taken during the inflammatory stage of the condition.

"Immunosuppressants have a wide range of benefits, but also side effects and limitations. So, we have a lot of new medication out now. Before, we used to only be able to use things like steroids, even chemotherapeutic agents like Methotrexate. Then we tried some immunomodulatory, and now we have Teppeza, which has been fantastic. It has helped tremendously. We have seen patients who have had such a dramatic response to the Teppezza infusions that even patients who we thought would definitely need surgery to decompress their eyes or to reposition them are doing so well that they don't end up needing surgery. So, it's pretty dramatic," explains Dr. Sami.

Her last bit of awareness about this condition is to encourage smokers to quit smoking. She says it can prompt or aggravate this condition.