Hyperthyroidism

Abstract

Objective: Thyroid eye disease presents a special challenge to the ophthalmologists withpathogenetic enigma & therapeutic dilemma. The objective of the study is to determine the frequency of mode ofophthalmic manifestation of thyrotoxicosis, rating of all components of “NOSPECS” classification system and todetermine the relative magnitude of low & high index orbitopathies. Design: Cross sectional study. Setting: Thedepartment of ophthalmology Allied Hospital / Punjab Medical College (PMC) & Punjab Institute of Nuclear medicine(PINUM) Faisalabad. Period: From 1 Apr 2004 to 31 st st March.2005. Material & Methods: 100 patients of all age &sex, after having diagnosed as thyrotoxic on the basis of positive laboratory investigations were subjected to a plannedocular examination according to the given protocol. An ophthalmopathy index scoring system was adopted to tabulatethe results. Results: Among 100 thyrotoxic patients, 72 were female & 28 were male with male to female ratio 1:26.The over all mean age was 36.59 ±13.81 years with 77 % of cases lying between 21-50 year of age. Orbitopathy wasfound in 74 % of thyrotoxic patients with relative distribution of eyelid retraction 56 %, soft tissue involvement 38 %,Proptoses 16%, restrictive myopathy 11%, corneal involvement 13 % and sight loss due to optic neuropathy 7 %. Thereis more occurrence of low index orbitopathy 83 % as compared to high index orbitopathy i.e 17 %. Conclusion: Theoccurrence of dysthyroid orbitopathy is not essentially present in all hyper thyroid patients. Only 3 out of 4 develop it.The frequency of manifestation of various eye lesions in descending order is eyelid retraction, soft tissue involvement,Proptosis, corneal involvement, myopathy & vision loss. Low index orbitopathy is more common & males are at morerisk of developing orbitopathy than females.