Thyroid eye disease Flashcards
1
Q
What is thyroid eye disease?
A
- This is seen in 25-50% of people with Graves’ disease.
- Eye disease may not correlate with thyroid disease.
- Eye disease may be the first presenting sign of Grave’s disease and can be worsened by treatment, typically with radioiodine.
- Retroorbital inflammation and lymphocyte infiltration results in swelling of the orbit.
2
Q
What is the main risk factor of thyroid disease?
A
Smoking
3
Q
Symptoms of thyroid eye disease
A
Eye discomfort Grittiness Increased tear production Photophobia Diplopia Decreased visual acuity Afferent pupillary defect
4
Q
Signs of thyroid eye disease
A
Exophthalmos- the appearance of a protruding eye.
Proptosis- eyes protrude beyond the orbit
Conjunctival oedema
Corneal ulceration
Papilloedema
Loss of colour vision
Ophthalmoplegia occurs due to muscle swelling and fibrosis.
5
Q
Investigations of thyroid eye disease
A
Diagnosis is clinical.
CT/MRI of orbits may reveal enlarged eye muscles.
6
Q
Management of thyroid eye disease
A
- Treat hyper/hypothyroidism
- Smoking cessation
- Mild disease can be treated symptomatically
- High-dose steroids in severe disease
- Surgical decompression used for severe sight-threatening disease
- Anti-TNFa antibodies (infliximab)- future options
7
Q
Causes of goitre
A
Diffuse- physiological, Grave’s disease, Hasmito’s thyroiditis, subacute thyroiditis.
Nodular- multinodular goitre, adenoma, carcinoma
