Authors : Sujithra H, Rizana V Mohammed
DOI : 10.18231/j.ijooo.2019.018
Volume : 5
Issue : 2
Year : 2019
Page No : 68-72
Aims: To quantify the clinical presentations, to study the complications and to quantify the response to different treatment modalities of Graves ophthalmopathy.
Materials and Methods: A retrospective study of 80 patients with Thyroid disorder who presented to Ophthalmology department of a tertiary health care centre in Kerala. All the patients were subjected to complete ocular examination which included Visual acuity, Tonometry, Colour vision testing, Hertels exophthalmometry, Slit lamp examination and Fundus examination. Clinical activity score of each patient at first visit was noted. All patients were specifically evaluated for exposure keratitis, lid signs and evidence of compressive optic neuropathy and secondary glaucoma.
Results: 58.8% were females. Lid retraction was the most common finding (63.75%). 52.50% had proptosis at presentation, of which 16.66% had severe proptosis. Among those with proptosis, 61.9% were males. 50% patients had Extraocular muscle involvement of which 2.5% showed involvement of all 4 recti muscles, 17.5% had 3 muscles, 37.5% had 2 muscles, 42.5% had single muscle involvement. 3.75% had optic nerve compression and 17.50% had glaucoma. 10% patients presented in active stage. 15% received intravenous methyl prednisolone, 3.8% underwent orbital decompression, 3.8% received radiotherapy and majority were managed conservatively.
Conclusion: Presentation of Graves ophthalmopathy varies from simple conjunctival congestion to vision threatening complication like optic nerve compression. Majority of patients presented in inactive stage. Those who presented in active phase and treated appropriately showed significant improvement, highlighting the need for prompt diagnosis and treatment of Graves ophthalmopathy when the disease is active.
Keywords: Graves ophthalmopathy, Proptosis, Dysthyroid optic neuropathy, Orbital decompression, Exposure keratopathy, Secondary glaucoma.