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Feature Article

Thyroid eye disease: preserving vision and function

HELMUT C.Y. YU, IAN C. FRANCIS, GEOFFREY WILCSEK

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Abstract

Thyroid eye disease can cause severe chronic eye discomfort, vision loss and appearance changes that may lead to reclusive behaviour. Early identification and prompt management of thyroid eye disease may reduce symptoms, preserve sight and allow patients to continue or resume normal activities of daily living.

Key Points

  • Hallmarks of thyroid eye disease (TED) are eyelid retraction, proptosis and restriction of ocular movements; however, patients with TED may also present with symptoms of chronic eye irritation alone.
  • Removal of the thyroid has little impact on the development of TED.
  • It is important to note that uctuations of thyroid function can exacerbate the course of TED.
  • Initial management of patients with TED comprises: – ensuring that the cornea is protected – ruling out optic neuropathy – correcting thyroid dysfunction – advising smokers to cease smoking with cessation programs.
  • Referral to an ophthalmologist is reasonable for any patient suspected to have TED as this disease potentially causes vision loss.

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