What is Endocrine Ophthalmopathy Disease ?
Endocrine Ophthalmopathy are the symptoms of inflammation of the tissues of the eyes. They become painful, red and moisturized. The membranes of the eye are inflamed and swollen. Eyeballs protrude from the orbits. Due to impaired movement of the eye muscle, the eyes cannot move normally, and vision may be blurry or ambivalent.
Key points:
- Signs And Symptoms
- Description
- Diagnostics
- Treatment
Endocrine Ophthalmopathy Signs And Symptoms:
- Sleep disturbance
- Double vision, blurred vision
- Tear
- Narrowing of visual fields
- Visual impairment
- Swelling of the eyelids
- Photophobia
- Exophthalmos
- Hot flashes (sensation of heat)
- Irritability
- Tremor
- Tachycardia
- Heartbeat
- Conjunctival edema
The characteristic features of Endocrine Ophthalmopathy disease are the symptoms of inflammation of the tissues of the eyes. They become painful, red and moisturized. The membranes of the eye are inflamed and swollen. Eyeballs protrude from the orbits. Due to impaired movement of the eye muscle, the eyes cannot move normally, and vision may be blurry or ambivalent.
Patients complain of lacrimation, especially in the wind, photophobia, a feeling of pressure in the eyes, double vision (especially when looking up and sideways), bulging eyeballs. On examination, marked exophthalmos, often bilateral.
With the edematous form of the disease, pronounced edema of the eyelids, conjunctiva is noted. With the predominant involvement of extraocular muscles in the pathological process, the symptoms due to their defeat come to the fore: symptoms of Moebius, Gref, Dalrimple, Stelvag, etc. limitation of the mobility of the eyeballs up to their complete immobility
Endocrine ophthalmopathy has three independent forms, which can pass into each other or be isolated.
- Thyrotoxic Exophthalmos
- Edematous Exophthalmos
- Endocrine Myopathy
Thyrotoxic exophthalmos can be unilateral or bilateral in nature, most often occurs in women and is characterized by increased irritability, sleep disturbance, and a feeling of heat. Patients complain of hand shake, palpitations, enlarged palpebral fissures, and occasional blinking. With the treatment of the thyroid gland, these symptoms disappear.
Edematous exophthalmos often develops in both eyes, but not always synchronously. The onset of the disease is indicated by the partial omission of the upper eyelid in the morning with the restoration of the palpebral fissure in the evening. Men and women with the same frequency get sick.
Without treatment, edematous exophthalmos leads to the development of complications such as corneal ulcer, immobility of the eyeball and decreased visual acuity due to atrophy of the optic nerve.
Endocrine myopathy is more common in men, occurs against hypothyroidism, usually on both sides. The onset of the disease is indicated by a symptom of double vision in the eyes, which is due to a limitation of eye mobility. Gradually, an increase in the eyeball is formed. Without treatment, the risk of developing fibrosis of the eye structures is high.
Endocrine Ophthalmopathy Description :
Endocrine ophthalmopathy (EOP) is an autoimmune disease of the tissues and muscles of the orbit, leading to the development of exophthalmos (protrusion of the eyeballs) and a complex of eye symptoms. The disease is based on autoimmune disorders leading to changes in extraocular muscles and retrobulbar fiber.
In the pathological process, soft tissues of the orbit are affected against the background of impaired thyroid function. The disease is caused by the reaction of antibodies and some white blood cells with proteins of the eye muscle, connective tissue and fatty tissue surrounding the eyeball.
This condition should be distinguished from mild ocular symptoms in the form of "bulging" eyes and spasm of the eyelids arising from the action of an excess of thyroid hormones, and found in patients with thyrotoxicosis .
Endocrine Ophthalmopathy was studied in more detail in the late 40s of the XX century. And then it turned out that suffering from a thyroid disease with the involvement of the organ of vision, are quite common.
In the medical literature over the course of all these years, a discussion continues about the cause of the protrusion of the eye, opinions are made about which tissues in the orbit suffer first. Many synonyms used in the literature until recently indicate the absence of a complete concept of the emergence and development of this extremely serious disease.
Endocrine Ophthalmopathy Diagnostics :
On examination, you can see that the eyes protrude from the orbits. This protrusion (exophthalmos) can be measured with a special instrument - an “exophthalmometer”. Normally, with exophthalmometry, eyeballs protrude 15-18 mm, with Endocrine Ophthalmopathy, this figure is 2-8 mm higher.
On the fundus, edema of the retina and optic discs, atrophy of the optic nerves are detected. There is a concentric narrowing of the visual fields, sometimes - ulceration of the cornea, its perforation, infection attachment.
Ultrasound examination is of great importance for the diagnosis, allowing you to determine the severity of damage and distinguish groups of affected oculomotor muscles, if necessary, computed or magnetic tomography, scintigraphy. Studies are also being appointed to identify the pathology of thyroid function.
Endocrine Ophthalmopathy Treatment :
Unfortunately, there are no adequate methods of treatment for Endocrine Ophthalmopathy disease, which is carried out jointly by an ophthalmologist and an endocrinologist, taking into account the severity of the disease and thyroid dysfunction. An indispensable condition for successful treatment is the achievement of an euthyroid state (the absence of clinical signs of thyroid dysfunction).
Since thyrotoxicosis affects ophthalmopathy, it is important to treat thyrotoxicosis quickly and effectively, while trying to avoid hypothyroidism , which also damages the eyes. In most patients, the eye condition improves somewhat with successful treatment of the thyroid gland.
In some patients, this disease progresses despite treatment of the thyroid gland. In this case, potent drugs, such as steroid hormones or immunosuppressants, are prescribed to prevent extremely undesirable complications such as swelling of the optic nerve and blindness.
If these measures do not affect within a few days, it may be necessary to reduce the pressure in the orbit by removing part of the tissue by surgery or by x-raying the eye. Both methods quickly reduce pressure on the eyeball and surrounding tissues of the orbit and prevent the development of irreversible damage to the optic nerve or glaucoma.
Symptomatic treatment is aimed at correcting the symptoms of the disease. In particular, antibiotic drops , eye ointment, eye protection from the sun and drying out are often prescribed .
According to the testimony, the doctor may recommend medications to reduce swelling, exophthalmos, to increase the volume of movement of the eyeballs, reduce unpleasant sensations in the eyes, dehydration preparations, stimulate neuromuscular conduction, and also improve metabolic processes in the oculomotor. In some cases, magnetotherapy to the orbit region is useful, in difficult situations, radiotherapy to the orbit region is prescribed.
After treatment, or when the eye symptoms go away on their own, eye inflammation rarely recurs and treatment is not required to continue. However, patients who have not previously had a thyroid disease should be examined regularly if they develop it.
Patients with eye disease who have already been treated for thyrotoxicosis should also be examined regularly to ensure that the thyroid gland is functioning properly, since a relapse of thyrotoxicosis or the development of hypothyroidism can cause a new outbreak of eye disease.
Therapeutic techniques consist in stabilizing the functions of the thyroid gland (achieving an euthyroid state). If these measures are ineffective, surgical tactics are used in treatment (thyroidectomy) followed by hormone replacement therapy.
Post a Comment