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KMK - Ocular Disease > Thyroid Eye Disease > Flashcards

Thyroid Eye Disease Flashcards

1
Q

Thyroid eye disease is also known as what?

A

Graves’ Opthalmopathy

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2
Q

What gender more frequently gets TED?

A

Female (8:1)

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3
Q

What decade of life does Graves’ usually set in?

A

4th to 5th

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4
Q

What is the strongest risk factor for the development of TED?

A

Smoking

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5
Q

What hormone levels will be abnormal in TED?

A

High T3 and T4

Low TSH

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6
Q

Why is TSH typically low in TED?

A

TED is caused by a TSH mimic, so due to negative feedback, TSH will be reduced by the body

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7
Q

What is Dalrymple’s sign?

A

Widened palpebral fissure - “staring eye”

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8
Q

TED is an autoimmune disorder in which TSH receptor antibodies are directed against what?

A

EOMs and orbital tissue

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9
Q

Does TED typically affect: 1. Just the EOM tendons, 2. Just the EOM muscles, or 3. Both the EOM tendons and muscles?

A
  1. Just the muscles - thickening
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10
Q

What are the common symptoms of TED?

A 
Dalrymple's sign
Chemosis
FBS
Tearing
Photophobia
Pain
Diplopia
Decreased VA
Color vision loss
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11
Q

What are the common signs of TED?

A 
Proptosis (unilateral or bilateral)
Upper lid retraction
Eyelid erythema/edema
Conj/caruncle injection and edema
Decreased color vision
EOM restrictions
APD
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12
Q

Thyroid eye disease is the most common cause of what?

A

Unilateral or bilateral proptosis in middle-aged patients

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13
Q

What is the grading system for TED?

A 
NO SPECS
N - no signs or symptoms
O - only signs; no symptoms
S - Soft tissue involvement (lid edema, conj chemosis, etc)
P - Proptosis
E - EOM involvmement (Diplopia)
C - Corneal involvment (SPK, SLK, ulceration)
S - sight loss (optic nerve compression
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14
Q

What causes optic nerve compression in TED?

A

Enlarged EOMs at the orbital apex

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15
Q

Why may sight loss occur in advanced TED?

A

Compression of the optic nerve head

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16
Q

What are the three signs named after scientists in TED?

A

Von Graefe’s sign
Kocher’s sign
Dalrymple’s sign

17
Q

What is Von Graefe’s sign?

A

Upper eyelid lag during downgaze

18
Q

What is Kocher’s sign?

A

Relative globe lag on upgaze in comparison to the upper lid

19
Q

What 5 things can be done to help diagnose TED?

A 
Forced ductions
CT/MRI
Exophthalmometry
Visual fields
T3/T4/TSH blood work
20
Q

What are the normal exophthalmometry readings for Caucasians?

A

12-22mm

21
Q

What are the normal exophthalmometry readings for Asians?

A

12-18mm

22
Q

What are the normal exophthalmometry readings for African Americans?

A

12-24mm

KMK - Ocular Disease (20 decks)

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