RESUMO
Myasthenia gravis can mimic central neurological disorders and should be considered in the differential diagnosis of any form of pupil-sparing ophthalmoplegia. We report an unusual manifestation of myasthenia gravis presenting as bilateral internuclear ophthalmoplegia (INO) of abduction, sometimes referred to as Lutz posterior INO (or reverse INO).
RESUMO
Orbital myositis is a rare extraintestinal manifestation of inflammatory bowel disease and has been reported to occur at variable times relative to gastrointestinal symptoms, including years before, concurrently to, and years after the gastrointestinal diagnosis. Here, the authors report 3 cases of Crohn's disease associated orbital myositis, adding to the 18 previously reported cases. The authors describe 2 cases of middle-aged females presenting with orbital myositis during clinical remission of Crohn's disease. The authors also describe the first reported case of orbital myositis-associated Crohn's disease diagnosed prior to any gastrointestinal symptoms in a teenage male presenting with corticosteroid responsive intermittent eyelid swelling. These cases underscore the importance of the Ophthalmic Plastic Surgeon in initiating a thorough systemic workup for cases of orbital inflammatory disease.
Assuntos
Doença de Crohn/complicações , Órbita/diagnóstico por imagem , Miosite Orbital/etiologia , Adolescente , Adulto , Colonoscopia , Doença de Crohn/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Miosite Orbital/diagnóstico , Tomografia Computadorizada por Raios XAssuntos
Anoftalmia/complicações , Anoftalmia/terapia , Olho Artificial , Inflamação/terapia , Neoplasias Orbitárias , Olho Artificial/efeitos adversos , Humanos , Inflamação/etiologia , Doenças Orbitárias/etiologia , Doenças Orbitárias/prevenção & controle , Neoplasias Orbitárias/prevenção & controle , Neoplasias Orbitárias/terapiaRESUMO
Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation.