Thyroid Orbitopathy

What is thyroid orbitopathy?

Thyroid orbitopathy is an autoimmune and self-limiting inflammatory condition characterized by changes in the orbital and periorbital soft tissues, which is usually related to alterations in the function of the thyroid gland, which cause a significant alteration in the quality of life. The disease is usually bilateral (85-95%) but it can appear unilaterally (5-15%).

orbitopatia tiroidea

Symptoms

The onset of symptoms is often progressive, gradual, a "gritty" sensation, tearing, photophobia, palpebral and conjunctival oedema, diplopia, palpebral retraction, exophthalmos, conjunctival chemosis, lagophtalmos, exposure keratitis, compressive optic neuropathy which can cause a decrease of visual acuity (if it is not treated promptly, it can cause an optic atrophy).

Management

The treatment of thyroid orbitopathy depends on the stage of the orbital disease (active-non-active), the degree of affectation and the patient's visual commitment. In the mild form, it is advised to protect the eyeball (wear dark glasses, use artificial tears, occlusion at night if there are lagophthalmos). In the moderate-severe form, if it is in an active phase, it is controlled with corticosteroids, other immunosuppressors or radiation therapy; and if it is in an inactive phase, depending on the clinical situation of the patient there may be requires strabismus surgery and/or palpebral retraction surgery.