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Ocular Disease > Dysthyroid Ophthalmology > Flashcards

Dysthyroid Ophthalmology Flashcards

1
Q

Other names of dysthyroid ophthalmopathy

A

Thyroid eye disease
Graves’ ophthalmopathy
Thyroid-associated ophthalmopathy
Thyrotoxic exophthalmos

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2
Q

Causes of thyrotoxicosis

A

Graves’ disease
Toxicmultinodular goiter
Toxic adenoma
Functioning thyroid carcinoma metastases
Activating mutation of TSH receptor
Iodine excess
Subacute thyroiditis
TSH secreting pituitary adenoma

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3
Q

an autoimmune disease with usually presents in the 3rd-4th decade of life and affects women more commonly than men

A

Graves’ disease

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4
Q

an autoimmune disorder that leads to overactivity of the thyroid gland

A

Graves disease

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5
Q

overactivity of the thyroid gland

A

Hyperthyroidism

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6
Q

a condition that occurs when the immune system mistakenly attacks healthy tissue

A

Graves’ disease

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7
Q

Accounts for 60-80% of thyrotoxicosis

A

Graves’ Disease

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8
Q

Most common cause of hyperthyroidism

A

Graves’ Disease

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9
Q

Most common cause of unilatetal or bilateral proptosis in adults or children 20-50 years of age

A

Graves’ Disease

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10
Q

Product of both environmental and genetic factors
Related factors: stress smoking

A

Graves’ Disease

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11
Q

Pathogenesis of Graves’ Disease

A

Product of both environmental and genetic factors
Stress
Smoking

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12
Q

clinical state of inappropriately high levels of circulating thyroid hormones (T3 and/or T4) in the body from any cause.

A

Thyrotoxicosis

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13
Q

It is often incorrectly used interchangeably with hyperthyroidism, which is a form of thyrotoxicosis caused by excessive endogenous thyroid hormone production.

A

Thyrotoxicosis

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14
Q

Normally the thyroid gland controls metabolism of the body and is important for regulating mood, weight, and mental and physical energy levels.

A

Graves disease

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15
Q

is an autoimmune condition in which autoantibodies are directed against the thyroid-stimulating hormone (TSH) receptor.

A

Graves disease

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16
Q

What is TSH

A

thyroid-stimulating hormone

17
Q

Risk factors for Graves disease

A

family history of hyperthyroidism or various other autoimmune disorders
•high iodine intake
•stress
•smoking

18
Q

The disease is classically characterized by the triad of goiter, exophthalmos, and pretibial myxedema.

A

Graves’ disease

19
Q

Cause of Graves’ disease

A

UNKNOWN
AUTOIMMUNE WITH LONG-ACTING
THYROID STIMULATOR

20
Q

Triad of symptoms of Graves’ disease

A

HYPERTHYROIDISM
• OPHTHALMOPATHY
• DERMOPATHY

21
Q

Symptoms of Graves’ disease

A

•hyperactivity, irritability ,dysphoria
•Heat intolerance and sweating
•Palpitations
•Fatigue and weakness
•Weight loss with increased appetite
•Diarrhea
•Polyuria
•Oligomenorrhea, loss of libido

22
Q

Signs of Graves’ disease

A

Tachycardia
•Tremor
•Goiter
•Warm, moist skin
•Muscle weakness
•Lid retraction or lag
•gynecomastia

23
Q

5 types of thyroid eye disease

A

Soft tissue involvement
Eyelid retraction
Proptosis
Optic neuropathy
Restrictive myopathy

24
Q

Signs of soft tissue involvement

A

Periorbital and lid swelling
Conjunctival hyperaemia
Chemosis
Superior limbic keratoconjunctivitis

25
Q

Occurs in about 50%

A

Eyelid retraction
Proptosis

26
Q

Signs of eyelid retraction

A

Bilateral lid retraction
Bilateral proptosis
Unilateral lid retraction
Unilateral proptosis
Lid lag in downgaze

27
Q

Occurs in about 50%
Uninfluenced by treatment of hyperthyroidism
Axial and permanent in about 70%
May be associated with choroidal folds

A

Proptosis

28
Q

Treatment for proptosis

A

Systemic steroids
radiotherapy
Surgical decompression

29
Q

Occurs in about 5%
Early defective color vision
Usually normal disc appearance

A

Optic neuropathy

30
Q

Caused by optic nerve compression at orbital apex by enlarged recti
Often occurs in absence of significant proptosis

A

Optic neuropathy

31
Q

Occurs in about 40%
Due to fibrotic contracture

A

Restrictive myopathy

32
Q

Most common in restrictive myopathy

A

Elevation defect

33
Q

Less common in restrictive myopathy

A

Abduction defect

34
Q

Uncommon in restrictive myopathy

A

Depression defect

35
Q

Rare in restrictive myopathy

A

Adduction defect

36
Q

Many scoring systems have been used to gauge the extent and activity of the orbital changes in Graves’ disease.

A

0 = No signs or symptoms
1 = Only signs (lid retraction or lag), no symptoms
2 = Soft-tissue involvement (periorbital edema)
3 = Proptosis (>22 mm)
4 = Extraocular-muscle involvement (diplopia)
5 = Corneal involvement
6 = Sight loss

37
Q

Treatment of Hyperthyroidism

A

Antithyroid medications
–Methimazole or tapazole
–Propylthiouracil
•Radioactive iodine
•Surgery

Ocular Disease (4 decks)

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