Thyroid

Question 1

What is the prevalence of thyroid eye disease?

Answer 1

Affects between 25-50% with Grave’s disease

Question 2

Features of Thyroid eye disease?

Answer 2

Pt may be eu-, hypo- or hyperthyroid at time of presentation
Exophthalmos
Conjunctival oedema
Optic disc swelling
Ophthalmoplegia
Unable to close eyelids—> sore,dry eyes (risk of keratopathy)

QM: proptosis, exopthalmos, lid lag, lid retraction, red,watery eyes

Question 3

Management of thyroid eye disease?

Answer 3

Topical lubricants to help prevent corneal inflammation
Steroids
Radiotherapy
Surgery

Question 4

In pts with established thryoid eye disease, what signs/symptoms prompt urgent review?

Answer 4

Unexplained deterioration in vision
Awareness of change in intensity or quality of colour vision in one or both eyes
Hx of eye suddenly popping out
Obvious corneal opacity
Cornea still visible when eyelids closed
Disc swelling

Question 5

Steps to prevent thyroid eye disease?

Answer 5

STOP SMOKING