Thyroid associated ophthalmopathy is a constellation of symptoms caused by an autoimmune process involving the orbital tissue. It is common in hyperthyroid patients due to Graves' disease and also reported in euthyroid and hypothyroid Graves' patients with positive thyroid receptor antibodies. But in Hashimoto's thyroiditis, thyroid associated ophthalmopathy is a rarely reported and poorly unde...

OBJECTIVE Thyroid eye disease (TED), an autoimmune inflammatory process involving the orbital tissues around the eye, is the most common extra-thyroidal manifestation of Graves' disease (GD). Due to changes in the patient's appearance, TED is a socially and visually disabling condition with significant impacts on quality of life. The aim of this study is to assess predictors of strabismus, a se...

BACKGROUND Graves' disease is a common autoimmune inflammatory condition of the thyroid. About one in four of affected patients also develop orbital symptoms like exophthalmos, proptosis and diplopia - called Graves' Ophthalmopathy. Not all patients respond well to the standard therapy of systemic glucocorticoid administration. The inflammatory swelling of the intraorbital muscles can lead to p...

Objective: Antibodies to eye muscle tissue are demonstrated in hyperthyroid Graves’ disease but their pathognomonic roles have not been clarified yet. We suggest that type 2 deiodinase (DIO2) enzyme can be a target between orbital and thyroid diseases in hyperthyroid Graves’ ophthalmopathy. In this study, the relationship between anti-eye muscle membrane (EyeM) and cytosol (EyeC) IgG, IgA and I...

Although ophthalmopathy is mainly associated with Graves' hyperthyroidism, milder eye changes are also found in about 25% of patients with Hashimoto's thyroiditis (HT). The recent finding of negative thyrotropin receptor (TSHR) antibodies, as measured in the Thyretain™ thyroid-stimulating immunoglobulin (TSI) reporter bioassay, in patients with euthyroid Graves' disease raises the possibility t...

We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. LEARNING POINTS It is importan...

A 27 year old woman with Graves' disease developed progressive ophthalmopathy and was noted to have abnormal visual evoked responses (VER). She was treated with high dose prednisone with clinical improvement and return of the visual evoked responses to normal. On withdrawal of steroids symptoms recurred and VER again were abnormal. Orbital irradiation was given with improvement in the ophthalmo...

PURPOSE To evaluate tear film quality by rose bengal staining and its stability by breakup time, relating with palpebral fissure height and exophthalmos in patients with Graves' ophthalmopathy. METHODS We studied 54 eyes of 27 patients with Graves' ophthalmopathy, either in the inflammatory or in the chronic phase of the disease. The evaluation consisted of tear film qualitative analysis by r...

The clinical manifestations of carotid cavernous fistula, an abnormal arteriovenous connection between the cavernous sinus and the carotid artery, can closely mimic the cardinal signs of Graves' ophthalmopathy, an inflammatory disorder of the orbit usually associated with autoimmune thyroid disease. Therefore, carotid cavernous fistulas are generally considered in the differential diagnosis of ...