Ocular Manifestations of Thyroid Disease

Day, Robert M.

doi:10.1001/archopht.1960.01840010326003

Cited by 24 publications

(7 citation statements)

References 69 publications

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“…She still could not recognize colors in the left eye. By January 6,1947, approximately six months after I saw her, vision corrected to 20/20 in each eye, and she could read newsprint with each eye. The left field was entirely normal.…”

Section: Discussionmentioning

confidence: 99%

Optic Nerve Involvement Associated with Thyroid Dysfunction

Day¹,

Carroll²

1962

Archives of Ophthalmology

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TEN PATIENTS WITH OPTIC NERVE INVOLVEMENT associated with thyroid dysfunction are reported in this study. This is the largest group reported from any one institution. Such optic nerve disease is relatively uncommon and most reports in the literature are limited to one or two cases. However, two series of six patients' 2 and one of four3 have been published in sufficient detail within recent years to be of value for comparison. Each patient had orbital changes characteristic of those associated with Graves' disease. These consisted of tearing and irritation of the eyes, as well as upper lid retraction, deep injection at the outer aspects of the globes, lid swelling, chemosis, and extraocular muscle involvement. All these signs were not present in every patient, but the clinical picture in each case suggested the correct diagnosis. Only one patient showed any corneal irregularity, and this was slight. The fundi were examined with dilated pupils to eliminate other causes for the visual disturbances. In each instance the ocular tension was normal. Papilledema or papillitis offered little difficulty in diagnosis, but retrobulbar optic nerve involvement was diagnosed only in the presence of consistent visual field defects. CASE REPORTS CASE 1 A 59-year-old white male who was treated for byperthyroidism with R.A.I. in December, 1957. One year later his lids became puffy, the eyes felt sandy, and he had double vision on upward gaze. When first seen on April 7, 1959, the lids were full, the lacrimal glands palpable, the upper lids retracted, both globes showed deep injection temporally and there was marked limitation of elevation as well as of lateral movement.

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Section: Discussionmentioning

confidence: 99%

Optic Nerve Involvement Associated with Thyroid Dysfunction

Day¹,

Carroll²

1962

Archives of Ophthalmology

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“…For instance, the name of Stellwag is associated with infrequent blinking and Pochin's sign refers to reduced blinking amplitude. 7,8 We have recently confirmed that spontaneous blink metrics are not normal in patients with GO. 9 Interblink time interval distributions have never been carefully studied in patients with GO.…”

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confidence: 65%

Spontaneous Interblink Time Distributions in Patients with Graves' Orbitopathy and Normal Subjects

Garcia

Pinto

Barbosa

et al. 2011

Invest. Ophthalmol. Vis. Sci.

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“…Upper eyelid retraction (Dalrymple’s sign) is the most significant periocular appearance of TAO and is listed as one of the major criteria for disease diagnosis (Bartley & Gorman, 1995; Cruz et al, 2013) [ 23 , 24 ]. Lower lid retraction, which is also a common feature of TAO, (Graves’ Eye Disease: Orbital Compliance and Other Physical Measurements-PubMed, n.d.) [ 25 ], has drawn less attention, and there is combat on the relation with the pathology of TAO (Day, 1960) [ 26 ]; however, lid retractions or malposition is a serious concern for ocular surface care, and may result in overocular exposure and thereby cause increased tear evaporation. More severe complications, such as exposure to keratitis, corneal ulcer, permanent corneal haze and vision impairment, may occur without prompt treatment (Kersten et al, 1990b; Olver et al, 1998a) [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Improvement of Ocular Surface Disease by Lateral Tarsoconjunctival Flap in Thyroid-Associated Orbitopathy Patients with Lid Retraction

Hsu

Hsieh

Chang

et al. 2022

JPM

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There is a high incidence of ocular surface disease (OSD) in thyroid-associated orbitopathy (TAO) patients as a result of incomplete eyelid closure and chronic inflammatory eyelid status. This study was performed to evaluate the efficacy of a lateral tarsoconjunctival flap (LTF) in improving OSD in TAO patients from the perspective of correcting eyelid closures. As a study design, TAO patients were enrolled in this study to evaluate OSD perioperatively before they were scheduled for LTF surgery. Additional lid surgery was also recorded. The outcome was evaluated with perioperative OSD measurements and tear inflammatory mediators at baseline and one month and three months postoperatively. As a result, 42 patients (5 male, 37 female) underwent LTF surgery, and 13 patients received medial pretarsal support with collagen grafts. Eleven patients underwent blepharotomy, and 6 patients received Botox injections for upper lid retraction. The mean age of the participants was 46.4 years old, and the mean follow-up period was 10.6 months. Their clinical activity score (CAS) at the time of the operation was 2.1. Dry eye parameters, such as ocular surface disease index, tear breakup time, Schirmer’s I test score, and meibomian gland dropout were all significantly improved 3 months postoperatively. Tear osmolarity and inflammatory mediators in tear fluid, such as IL-6, IL-8, IL-18 and MCP-1, were also significantly improved after the procedures. After the surgery, all complications were mild and temporary. As a conclusion, LTF could provide TAO patients with both lid retraction correction and improvement of ocular surface disorders. Dry eye parameters significantly improved 3 months postoperatively. This method can serve as an alternative treatment option for lid correction in TAO patients.

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Ocular Manifestations of Thyroid Disease

Cited by 24 publications

References 69 publications

Optic Nerve Involvement Associated with Thyroid Dysfunction

Optic Nerve Involvement Associated with Thyroid Dysfunction

Spontaneous Interblink Time Distributions in Patients with Graves' Orbitopathy and Normal Subjects

Improvement of Ocular Surface Disease by Lateral Tarsoconjunctival Flap in Thyroid-Associated Orbitopathy Patients with Lid Retraction

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