Thyroid eye disease Flashcards
1
Q
Background: Thyroid eye disease (prevalence etc)
A
- seen in 20-50% of people with Grave’s disease
- The eye disease may not correlate with thyroid disease and the patient can be euthyroid, hypothyroid or hyperthyroid at presentation
- Eye disease may be the first presenting sign of Grave’s disease, and can also be worsened by treatment
2
Q
Pathophysiology of TED
A
Retro-orbital inflammation and lymphocyte infiltration results in swelling of the orbit
3
Q
Risk factors TED
A
main known risk factor is smoking
4
Q
Symptoms of TED
A
- eye discomfort
- grittiness
- increased tear production
- photophobia
- diplopia
5
Q
Signs of TED
A
- exopthalmos → protoding eyes
- proptosis → eyes produce beyond the orbit
- conjunctivial oedema
- corneal ulceration
- papilloedema
- loss of colour vision
6
Q
Investigation/diagnosis of TED
A
- diagnosis is clinical
- CT/MRI of the orbits may reveal enlarged eye muscles
7
Q
Treatment: TED
A
- get specialist help
- treat hyper or hypothyroidism
- advise to stop smoking → worse prognosis
- mild → can be treated symptomatically
- severe → high-dose steroids (IV methylprednisolone is better than prednisolone 100mg/day PO)
- Surgical decompression is used for severe sight-threatening disease, or for cosmetic reasons
- Eyelid surgery → cosmetic and function
