TED Flashcards
Hyperthyroidism
Circulating TSH antibodies
Smoking women middle age HLA DR3 HLA B8
Target antigen bw orbit and thyroid is shared
IgG + antigen on the fibroblast adipocyte lineage inflammatory cascade»adipogenesis+fibroblast production+ GAG synthesis» EOM enlargement
4-8 x normal size tendons not involved Inf and medial recti involved Proptosis Exophthalmos Papillodemea
Fibrous replacement
Restricted myopathy
Diplopia
Neuropathy
Systemic Weight loss Heat intolerant Sweating Tachycardia Tremors
Ocular
Photophobia lacrimation
Retrobulbar discomfort
Pain proptosis red eye
Retraction of upper eyelid
Overacting of Muller muscle
Dalrymples sign
Unilateral and bilateral
Staring apperance
Kocher sign
Life lag
Globe moved down (Von Graefe sign
(Infrequently blink) Stellwag sign
Soft tissue sign
Periorbital sign
Eyelids puffy and swell cuz infiltration behind septum
Conjuctival
Hyperemia and chemosis
Sup limbic keratoconjuctivis
Keratoconjuctivis sicca
Proptosis
60 pc on case of the disease
Gradually or suddenly
Keratitis if severe
Optic neuropathy if nerve compressed by recti muscle enlargement
Papillodemea or optic atrophy
Restricted myophathu Ocular motility restricted Elevation defect Convergence defect Raised IOP diplopia
NOSPECS
None Lid retraction Soft tissue Proptosis EOM Corneal Slight loss
Investigation
TSH Serum Radioactive iodine uptake Ultrasonography CTMRI
Clotrimazole
Radioactive iodine
Thyroidectomy
Tears,, lubricants, taping of eyes, NSAIDS,
Orbital decompression
Corticosteroids
EOM surgery
Tarsorharrhaphy
