Dysthyroid eye disease
Dysthyroid eye disease
Description, Causes and Risk Factors:
The thyroid is a small, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland located in the brain.
Dysthyroid eye disease also known as Graves' ophthalmopathy or thyroid-associated ophthalmopathy, is the most frequent extrathyroidal manifestation of autoimmune hyperthyroidism (Graves' disease); 25-50% of patients with Graves' disease have eye involvement, of whom 3-5% develop severe disease.
The etiology of is complex. Genetic susceptibility and endogenous and environmental factors play a role in its development. The genetic factors are poorly defined but appear to have the lesser role. The risk of developing dysthyroid eye disease increases with age and women are more likely to develop Graves disease than men.
Most people with dysthyroid eye disease have or had or will subsequently develop an overactive thyroid gland.
Overactivity of the thyroid gland is usually caused by an "autoimmune condition." This means that cells which normally protect the body from infection develop a "fault" and begin to recognize the thyroid gland as foreign material and attack it. This stimulates the thyroid gland to produce extra thyroid hormones. The attacking process may spill over to the cells behind the eye causing them to swell. It is not yet known why cells develop the fault that causes them to attack the thyroid gland or why only some patients with overactivity of the thyroid develop dysthyroid eye disease. Dysthyroid eye disease does appear to be more common in smokers.
Symptoms may include:
The eyelids and tissue around the eyes become puffy because of fluid retention, which is usually worse after sleeping.
Exophthalmos (protrusion of the eyeball from the socket).
Diplopia (double vision).
Conjunctivitis (inflammation of the inner eyelids).
Diminished visual acuity (blurry or distorted vision).
Photophobia (sensitivity to light).
The eyes have a gritty sensation and are sore, irritated, red and watery.
Diagnosis is usually made on the basis of the patient's clinical signs and symptoms. However, further tests are clinically useful for determining the type and extent of orbital involvement. The enlarged extraocular muscles can be detected by A-scan or B-scan ultrasonography, or by a CT (computerized tomography) scan. CT scan is especially important when proptosis is not obvious since there is a tendency for apical muscle enlargement in some cases, which can produce compression of the optic nerve. It is also mandatory that patients exhibiting dysthyroid eye disease also be examined and assessed for thyroid disease.
Blood tests: Sometimes, blood tests are needed to back up the diagnosis. They look at how well the thyroid gland is functioning by measuring its hormones (chemical messengers) in your bloodstream. These are called thyroid function tests (TFTs). More specialized blood tests can be done to measure the antibodies in your blood.
Its treatment, despite recent developments, is still challenging, and complete improvement of functional and/or cosmetic impairment is not always possible.
Mild-to-moderate cases of dysthyroid eye disease usually resolve within a few months to two years without specific eye treatment. Patients can use artificial tears to soothe irritated eyes, and if double vision occurs, special glasses with prism lenses can help. Unfortunately, the double vision may not resolve completely, and many patients continue to have bulging eyes even after other symptoms disappear.
In patients whose eye disease progresses even after thyroid treatment, the doctor may prescribe corticosteroids to reduce swelling and inflammation around the eyes. Immunosuppressant drugs also are a possibility, or a combination of the two.
Surgery is an option for improving the appearance of the eyes. The function and appearance of the eyes can usually be improved by reconstructive eyelid or orbital surgery. Surgical treatment is generally delayed until the active inflammation subsides. The particular surgical technique used will depend on the type and severity of the eye problems.
Risks and benefits of the surgery should be discussed with your surgeon.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
Numerous studies conducted earlier showed that regular exercises have a positive effect on physical and mental health. The new work of American scientists confirms this. They believe that running five kilometers once a day is useful for the hippocampus (the brain...
According to a new research from Brunel University London in the United Kingdom, listening to music during performing exercise may help us enjoy working out more. To get the results of the study, a team of scientists used electroencephalography technology (EEG) to...
Quiz about this article
0 of 2 questions completed
Please answer on few questions to make our service more useful
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
0 of 2 questions answered correctly
Time has elapsed
You have reached 0 of 0 points, (0)
Question 1 of 2
Was this article useful for you?Correct
Thanks for your feedback!Incorrect
Thanks for your feedback!
Question 2 of 2
What else information about this disease you want to know ?Correct
Thanks for feedback!Incorrect
Thanks for feedback!
Many people spontaneously decide starting to do sport, while others weigh all the pros and cons for a log time. But almost all of them make the same mistakes, listening to the advice of non experts. There are 10 anti-tips for those who want to do plan to do some sport...read more
Spring is not far off and very soon you will see many people riding a bike. It's worth to join them and now we will give you the 8 reasons why. Weight control Scientists of the University of Surrey (England) found that it's enough riding a bike for an hour, and, not...read more
We all want to get in shape and keep fit. But not everyone has time for visiting the gym. Give up the elevator. Give up lifts and climb the stairs. At work, at home, at the mall. This simple advice is a great benefit if you follow it daily. Climbing the stairs...read more