Thyroid Eye Disease

Question 1

Describe the pathophysiology of thyroid eye disease.

Answer 1

Retro-orbital inflammation due to glycosaminoglycan and collage deposition in the muscles.

Question 2

What can you advise to prevent it?

Answer 2

• Stop Smoking - most important factor

Question 3

What hyperthyroid treatment can worsen eye disease>?

Answer 3

Radioiodine treatment

Question 4

How can you manage thyroid eye disease?

Answer 4

• Topical lubricants may be needed to help prevent corneal inflammation caused by exposure
• Steroids
• Radiotherapy
• Surgery

Question 5

When should someone with thyroid eye disease be referred to an opthalmologist?

Answer 5

• Unexplained deterioration in vision
• Awareness of change in intensity or quality of colour vision in one or both eyes
• History of eye suddenly ‘popping out’ (globe subluxation)
• Obvious corneal opacity
• Cornea still visible when the eyelids are closed
• Disc swelling

Question 6

What are some features of thyroid eye disease?

Answer 6

• Exophthalmos
• Conjunctival oedema
• Optic disc swelling
• Ophthalmoplegia

Question 7

If someone has the inability to close his eyes due to thyroid eye disease, what is a complication?

Answer 7

Sore, dry eyes.

If severe and untreated patients can be at risk of exposure keratopathy