CLINICAL REVIEW Thyroid eye disease

Thyroid eye disease is a relatively rare condition, with an incidenceof 2.9 to16.0 casesper100 000population per year. The disease mainly affects women. Many patients experience distressing symptoms, and a few develop sight threatening complications. Patients are often young or middle aged and at the peak of their career. Most patients are very aware of their altered appearance. Sight loss canbepreventedbyappropriate management, yet it still occurs even in countries with advanced healthcare systems. This problem is largely due to delays in starting treatment, because health professionals are not always aware of the remarkable difference that treatment can make in restoring visual function and appearance. For example, treatment can reverse blindness and help a reclusive patient to become socially reintegrated. Referral to specialist centres is appropriate for all but the mildest cases.