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Thyroid eye disease

 

Ocular and orbital inflammation could be associated with thyroid inflammation.  Graves’ disease, which is usually associated with increase secretion of the thyroid hormone, is the most encountered thyroid eye disease.

The disease affects female more than man, in there thirties and forties, but it could affect all age groups and when it presents in childhood it is usually mild.

The hall mark of the disease is the inflammation of the orbital soft tissue, including ocular appendages, such as the external ocular muscle and conjunctiva, and it is also associated with orbital fat hypertrophy, which cause the eyeball to move forward and cause proptosis (eye ball advancement).

Thyroid eye disease goes through inflammatory period, which could last for months, then the inflammation subsides and fibrosis takes place that might cause muscle restriction and limitation of the eye movements, causing double vision.

If the orbital inflammation is very severe, it could threaten the vision by causing optic nerve compression, which need an urgent intervention to save the vision.

Patient with thyroid eye disease usually complain of achy feeling around the eye, redness of the eye, dry eye symptoms, eye lid retraction which gives the appearance of big eyes, blurred vision which could be related to dry eyes or to optic nerve compression.

Patients with thyroid eye disease need to be managed under ophthalmic and endocrinology specialists to control both ophthalmic and systemic manifestations of the disease.