A rare case of acute thyroid eye disease in a young male

Thyroid Eye Disease also known as Thyroid Associated Orbitopathy, Grave’s Disease is typically a self-limiting autoimmune process associated with dysthyroid states usually manifesting in middle age. The clinical presentation may vary from very mild disease to severe irreversible sight threatening complications. Primary risk factors for TED are environmental influences especially smoking, previous pathogen exposures, stress, previous use of radio iodine and complex genetic components. Here we report a case of 25-year-old male who presented to our OPD with complaints of swelling of eyes, photophobia, lacrimation since 3days. Bilateral mild proptosis, severe congestion and conjunctival injection with 20/20 vision in both eyes were noted on examination. Blood investigations showed Eu-clinical Thyroid state whereas MRI Brain and Orbits showed all four Recti muscle belly enlargement. This case emphasizes one of the rare presentations of TED in accordance to Age, Sex and Clinical status of the thyroid.

A Case of Transnasal Endoscopic Orbital Decompression in Grave's Ophthalmopathy / 대한이비인후과학회지

Grave's disease is an autoimmune disorder and affects thyroid gland and orbit. Ocular manifestations of this disease, referred to as Grave's ophthalmopathy are caused by deposition of antithyroglobulin immune complexes into extraocular muscles and orbital fats. Consequent increase in volume of orbital contents results in exopthalmos. Severe exopthalmos results in several significant visual consequences as follows: exposure keratitis, diplopia and optic neuropathy. Orbital decompression for Grave's ophthalmopathy has traditionally been performed through either an external or a transantral approach. The advent of intranasal endoscopes allowed for the development of a transnasal approach for medial and inferior orbital wall decompression. Recently, the authors experienced a case of Grave's ophthalmopathy complicated with exposure keratitis and performed endoscopic transnasal orbital decompression, so report this case with a review of literature.

Radiotherapy for Grave's Ophthalmopathy / 中华放射肿瘤学杂志

Purpose: To review radiotherapy for Grave's ophthalmopathy. Materials and Methods: From 1964 through 1992, 94 patients with Grave's Ophthalmopathy (4 unilateral and 90 bilateral lesions) were treated by radiotherapy with the doses of 9～25Gy. Results: The overall effective rate was 83%. Edema of the eyelid , proptosis and ophthalmalgia were significantly improved. No complication of pituitary gland was found for patients whose pituitary glands were involved in the radiation ports. Conclusion: Radiotherapy is effective for Grave's Ophthalmopathy. The radiation dose advised is 20～25Gy/3wks.