Confidence restored: Anguru's journey back to ‘normal’

As a professor of mathematics at UW-Platteville, he was used to lecturing in front of students, running meetings, and speaking at symposiums and conferences. Then the bulging eyes started, and life became a lot more complicated.

“When I would go up to the podium to talk, I knew that everybody could see that there was something wrong with my eyes,” he said. “People were considerate, but I was self-conscious.”

But now, after undergoing a comprehensive treatment plan and having successful reconstructive surgeries – all under the care of UW Health specialists – Premadasa officially has his confidence back.

“Achieving such a great outcome in care required a well-coordinated team effort over several years,” said UW Health oculoplastic surgeon Mark Lucarelli, MD, FACS. “Working together made this all possible.”

It all began around 2016, when Premadasa first noticed significant redness in his eyes. Evaluation by a doctor confirmed a case of Graves’ disease, an autoimmune disorder that affects the thyroid and can cause inflammation and damage to the tissues around the eyes.

Facing this diagnosis, Premadasa scoured the internet for more information.

“I found that one of the nation's top physicians for Graves' eye disease, Dr. Lucarelli, was actually right here at UW, about a 15-minute drive from my home,” he said. “So, I just asked my primary care provider for a referral and that’s how it all started.”

At their first appointment together in November 2016, Lucarelli had Premadasa complete a questionnaire known as the TED-QOL, which measures quality of life for thyroid eye disease patients.

“Even though thyroid eye disease is not fatal, it can wreak havoc your life,” Lucarelli said. “It distorts how you look and how you feel. In the most severe cases, it can even take away your sight.”

At the initial consultation, Lucarelli laid out a multi-pronged treatment plan to help stop further damage to the eyes. The plan included a series of high dose steroid infusions and consultation with a UW Health radiation oncologist for orbital radiotherapy. The goal of these two therapies was to stop the severe inflammation around Premadasa’s eyes, which was causing the bulging and double vision.

The treatment path, Lucarelli said, would take time – twelve weeks of steroid treatment and ten radiation sessions – but it offered the best path forward. Premadasa also opted for the surgical removal of his thyroid, which proved to be beneficial in his case.

“Dr. Lucarelli told me at the very beginning that I could get back to normal if I followed the science,” Premadasa said. “A good surgeon and the science can take care of this problem. It's not something that you need to live with for your entire life.”

In early 2020, after the previous treatments brought the inflammatory process under control, Premadasa was able to begin the reconstructive phase of care. First, orbital decompression was performed on his left eye. This surgery involved the removal of bone around the eyes to create more space and allow the eyes to rest in a more normal position.

A few months later, he underwent the same procedure on the right eye. These two surgeries dramatically reduced the bulging of Premadasa’s eyes, and as an unexpected bonus, also eliminated the double vision he had also experienced in recent years.

After a recovery period, Premadasa subsequently underwent eyelid retraction surgery by Dr. Lucarelli to allow his upper eyelids to cover his eyes better. This surgery not only helped improved comfort, but also helped restore his appearance.

For Premadasa, the journey of many consultations and office visits, steroid infusions, radiation therapy, and several surgeries at UW Health has been a long one. But he says that each step was worth taking, because his vision is back to normal and his appearance has been restored.

“I’m more self-confident when I go to make a presentation or teach a class or take a photograph with my family,” he said. “I’m very lucky to live in Madison and to have been treated by such a talented team. They are phenomenal people who are really good at their craft and their skill level is absolutely amazing.”

As for Lucarelli, he adds, “It was extremely gratifying to see Dr. Premadasa come through this so well and to hear him speak about what a difference our care made in his life. Improving another person’s life in such a positive way is really one of the greatest joys of being a physician.”