Thyroid eye disease Flashcards
Thyroid eye disease
Autoimmune disorder with an active inflammatory phase and inactive fibrotic phase
What is thyroid eye disease associated with
Hyperthyroidism but can also be hypothyroid
Investigations for thyroid eye disease
TFTs Anti thyroid antibodies - anti TPO, anti TSH FBC, U+Es, LFTs CRP Weight anf blood pressure TPMT Urinanalysis CXR Photograph eyes CT/MRI - decompression
Presentation of thyroid eye disease
Gritty watery eyes Puffy eyelids Proptosis - bulging eyes Optic neuropathy Upper lid retraction Lid lag Increased intraocular pressure Strabismus Diplopia
Proptosis
Eyes bulge forward
Management of thyroid eye disease
Control thyroid levels:
- anti-thyroid medication
- thyroidectomy
Orbital decompression surgery
Steroids for inflammatory phase
Strabismus surgery or lid surgery - fibrotic phase
Advice:
- stop smoking
Complications of thyroid eye disease
Exposure keratitis - lid extraction Glaucoma - due to proptosis Choroidal folds Strabismus Optic nerve compression
Which management is contraindicated in thyroid eye disease
Radioactive iodine ablation - makes thyroid eye disease worse
Presentation of hyperthyroidism
Intolerance to heat Weight loss Appetite increased Sweaty Hair thinning Tachycardia Nervousness Tremor
Presentation of hypothyroidism
Intolerance to cold Weight gain Appetite loss Bradycardia Constipation Depression Dry skin Muscle cramps
Conditions associated with Grave’s disease
Pernicious anaemia Vitiligo T1DM Myasthenia gravis Sjogrens RA SLE