Thyroid Eyelid Retraction

  • David R. Jordan
  • Richard L. Anderson


Eyelid retraction is a common feature of thyroid eye disease. It may result in exposure keratopathy with symptoms including blurred vision, photophobia, foreign body sensation, burning, and tearing. Numerous surgical procedures have been suggested over the past few decades with both anterior and posterior approaches to the levator and Müller’s muscle as well as a variety of spacer grafts. A graded levator/Müller’s recession and resection with lateral horn transection is our preferred technique for the upper eyelid. A full-thickness blepharotomy is another useful technique in the upper lid. Retractor disinsertion on its own or more often with a spacer graft (e.g., ear cartilage, hard palate mucosa) is our preferred technique in the lower eyelids.


Lid retraction Levator recession Levator/Müller’s recession Blepharotomy Spacer grafts 

Supplementary material

419986_5_En_22_MOESM1_ESM.mp4 (103.4 mb)
Video 22.1 Upper lid full-thickness blepharotomy (modified full-thickness blepharotomy). Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 105837 kb)
419986_5_En_22_MOESM2_ESM.mp4 (221.7 mb)
Video 22.2 Upper lid full-thickness blepharotomy with fat excision (full-thickness blepharotomy with debulking of medial and brow fat pads). Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 226982 kb)
419986_5_En_22_MOESM3_ESM.mp4 (189.1 mb)
Video 22.3 Placement of spacer to lower lid (Enduragen graft). Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 193622 kb)
419986_5_En_22_MOESM4_ESM.mp4 (303.3 mb)
Video 22.4 Placement of ear cartilage (lower lid elevation with ear cartilage graft). Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 310533 kb)
419986_5_En_22_MOESM5_ESM.mp4 (100.1 mb)
Video 22.5 Hard palate graft for lower eyelid retraction. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 102498 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • David R. Jordan
    • 1
  • Richard L. Anderson
    • 2
  1. 1.Department of OphthalmologyOttawa General Hospital, Eye InstituteOttawaCanada
  2. 2.AO Surgical ArtsSalt Lake CityUSA

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