Thyroid Eye Disease

Question 1

Definition

Answer 1

Denotes typical ocular changes which includes lid lag , lid retraction and proptosis associated with thyroid abnormalities .

Question 2

Etiology

Answer 2

Associated with hyperthyroidism
Female
Cigratte
Autoimmune thyroid disease
Hla dr3 , hla b8 association

Question 3

Classification

Answer 3

@NO SPECS
N = No signs or symptoms
Only signs ( lid retration with or without lid lag and proptosis )
S= Soft tissue involvement with signs and symptoms (lid and conjunctival edema ,lacrimation , photophobia )
P= Proptosis well established
E= Extraoccular muscle involvement( limitstion of movement and diplopia )
C= corneal involvement
S= sight loss due to optic nerve involvement +disc pallor +papilloedema +visual field defect

Question 4

Symptoms

Answer 4

Redness
Irritation
Dry eyes
Decrease vision
Proptosis
Diplopia
Pain
Visual field defect
Colour vision defect

Question 5

Signs

Answer 5

Lid signs
Conjunctival signs
Ocular motility defect
Exopthalmos
Exposure keratopathy
Optic neuropathy
Optic atrophy

Question 6

Investigation

Answer 6

Colour vision test
Thyroid function test
Thyroid antibody test
Visual field examination
Ultrasonography
CT scan
MRI

Question 7

Treatment

Answer 7

General measure
Tt of thyroid
Dry eye tt
Exposure keratopathy tt
Corticosteroid
Orbital radiation therapy
Combined therapy = steroid +azathioprine + irradiation
Orbital decompression sx
Extraocular muscle sx
Eyelid sx

Question 8

Lid signs

Answer 8

Dalrymple sign
Von graefes sign
Enroth sign
Gifford sign
Stellwag sign

Question 9

Conjunctival sign

Answer 9

Chemosis
Kerato conjunctivitis

Question 10

Ocular motility defect

Answer 10

Mobius sign