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Thyroid eye disease

Thyroid eye disease goes through an inflammatory stage, which present it self as ocular pain, redness, swelling of the conjunctiva and the eyelids, and possible vision deterioration as a result of optic nerve compression or eye exposure.

The treatment in the active inflammatory phase is usually conservative with anti-inflammatory drugs, like the steroid, which could be given intravenously, in severe cases that threaten the optic nerve.

After the inflammatory stage comes the fibrotic stage, which could cause restriction of the ocular movements, eyelid retraction, and proptosis of the eyeball due to hypertrophied ocular muscle and orbital adipose tissue.

The treatment paradigm for the fibrotic complications of the thyroid eye disease, usually start with dealing with orbital manifestations first, such as the proptosis, which is treated with orbital decompression procedures. Then ocular movements problem need to be addressed if present, such as double vision resulting from extraocular muscle restriction, and at last is the management of the eyelid position (lid retraction).

These procedures are usually done under general anaesthesia.