Podcast
Questions and Answers
What is the most common cause of both bilateral and unilateral proptosis in an adult?
What is the most common cause of both bilateral and unilateral proptosis in an adult?
What is the major clinical risk factor for developing TED in patients with Graves disease?
What is the major clinical risk factor for developing TED in patients with Graves disease?
Who is more likely to be affected by TED?
Who is more likely to be affected by TED?
What can worsen TED in patients with hyperthyroidism?
What can worsen TED in patients with hyperthyroidism?
Signup and view all the answers
What is the initial treatment option for acute compressive optic neuropathy?
What is the initial treatment option for acute compressive optic neuropathy?
Signup and view all the answers
Which treatment may be used in addition to steroids or when steroids are contraindicated or ineffective?
Which treatment may be used in addition to steroids or when steroids are contraindicated or ineffective?
Signup and view all the answers
What is a potential adverse effect of the treatment for acute optic nerve compression?
What is a potential adverse effect of the treatment for acute optic nerve compression?
Signup and view all the answers
What combined therapy may be more effective than steroids or radiotherapy alone?
What combined therapy may be more effective than steroids or radiotherapy alone?
Signup and view all the answers
What is a potential consequence of orbital decompression?
What is a potential consequence of orbital decompression?
Signup and view all the answers
What is the most commonly indicated surgery for restrictive myopathy?
What is the most commonly indicated surgery for restrictive myopathy?
Signup and view all the answers
What may be used for mild lid retraction?
What may be used for mild lid retraction?
Signup and view all the answers
What is used for post-inflammatory complications in TED?
What is used for post-inflammatory complications in TED?
Signup and view all the answers
What percentage of TED patients develop long-term ocular problems?
What percentage of TED patients develop long-term ocular problems?
Signup and view all the answers
What is a symptom of soft tissue involvement in TED?
What is a symptom of soft tissue involvement in TED?
Signup and view all the answers
What can lid retraction in TED result in?
What can lid retraction in TED result in?
Signup and view all the answers
What percentage of TED patients develop permanent ophthalmoplegia?
What percentage of TED patients develop permanent ophthalmoplegia?
Signup and view all the answers
What is a clinical feature of TED?
What is a clinical feature of TED?
Signup and view all the answers
What is a complication of TED that can cause severe visual impairment?
What is a complication of TED that can cause severe visual impairment?
Signup and view all the answers
What is a part of the treatment for mild TED?
What is a part of the treatment for mild TED?
Signup and view all the answers
What is an investigation for TED patients to check for optic nerve compromise?
What is an investigation for TED patients to check for optic nerve compromise?
Signup and view all the answers
What is a consequence of proptosis in TED?
What is a consequence of proptosis in TED?
Signup and view all the answers
What is a stage that TED proceeds through?
What is a stage that TED proceeds through?
Signup and view all the answers
What should be managed as part of TED treatment?
What should be managed as part of TED treatment?
Signup and view all the answers
What is a feature of moderate to severe active TED disease treatment?
What is a feature of moderate to severe active TED disease treatment?
Signup and view all the answers
TED is not a common orbital disorder and rarely causes proptosis in adults.
TED is not a common orbital disorder and rarely causes proptosis in adults.
Signup and view all the answers
Smoking is a major clinical risk factor for developing TED in patients with Graves disease.
Smoking is a major clinical risk factor for developing TED in patients with Graves disease.
Signup and view all the answers
Women are less likely to be affected by TED than men.
Women are less likely to be affected by TED than men.
Signup and view all the answers
Thyroid ophthalmopathy involves an autoimmune reaction that leads to inflammation of extraocular muscles, orbital fat, and lacrimal glands.
Thyroid ophthalmopathy involves an autoimmune reaction that leads to inflammation of extraocular muscles, orbital fat, and lacrimal glands.
Signup and view all the answers
Oral prednisolone is the first-line treatment for acute compressive optic neuropathy in TED.
Oral prednisolone is the first-line treatment for acute compressive optic neuropathy in TED.
Signup and view all the answers
Low-dose fractionated radiotherapy is used as the sole treatment for acute optic nerve compression.
Low-dose fractionated radiotherapy is used as the sole treatment for acute optic nerve compression.
Signup and view all the answers
Around 60% of patients with TED do not respond to treatment.
Around 60% of patients with TED do not respond to treatment.
Signup and view all the answers
Orbital wall decompression may be considered if steroids are ineffective or contraindicated in TED.
Orbital wall decompression may be considered if steroids are ineffective or contraindicated in TED.
Signup and view all the answers
Orbital radiotherapy is generally used as the sole treatment modality in TED.
Orbital radiotherapy is generally used as the sole treatment modality in TED.
Signup and view all the answers
Eyelid surgery should be performed before any necessary orbital and then strabismus procedures in TED.
Eyelid surgery should be performed before any necessary orbital and then strabismus procedures in TED.
Signup and view all the answers
Surgical decompression for proptosis in TED involves increasing the volume of the orbit by adding bony walls.
Surgical decompression for proptosis in TED involves increasing the volume of the orbit by adding bony walls.
Signup and view all the answers
Botulinum toxin injection to the levator aponeurosis and Müller muscle is ineffective for mild lid retraction in TED.
Botulinum toxin injection to the levator aponeurosis and Müller muscle is ineffective for mild lid retraction in TED.
Signup and view all the answers
Thyroid Eye Disease progresses through congestive and fibrotic stages, with 90% of patients developing long-term ocular problems.
Thyroid Eye Disease progresses through congestive and fibrotic stages, with 90% of patients developing long-term ocular problems.
Signup and view all the answers
Lid retraction occurs in about 50% of TED patients.
Lid retraction occurs in about 50% of TED patients.
Signup and view all the answers
Proptosis in TED can lead to exposure keratopathy and corneal ulceration.
Proptosis in TED can lead to exposure keratopathy and corneal ulceration.
Signup and view all the answers
Between 30% and 50% of TED patients develop permanent ophthalmoplegia.
Between 30% and 50% of TED patients develop permanent ophthalmoplegia.
Signup and view all the answers
Optic neuropathy is not a serious complication of TED and does not cause severe visual impairment.
Optic neuropathy is not a serious complication of TED and does not cause severe visual impairment.
Signup and view all the answers
Investigations for TED include blood tests for thyroid disease and visual field testing for optic nerve compromise.
Investigations for TED include blood tests for thyroid disease and visual field testing for optic nerve compromise.
Signup and view all the answers
Mild TED treatment includes cessation of smoking, management of thyroid dysfunction, and use of lubricants, topical anti-inflammatory agents, and systemic steroids.
Mild TED treatment includes cessation of smoking, management of thyroid dysfunction, and use of lubricants, topical anti-inflammatory agents, and systemic steroids.
Signup and view all the answers
Moderate to severe active TED disease is not treated with systemic steroids.
Moderate to severe active TED disease is not treated with systemic steroids.
Signup and view all the answers
Soft tissue involvement in TED presents with symptoms like red eyes, lacrimation, and signs such as epibulbar hyperemia and tear insufficiency.
Soft tissue involvement in TED presents with symptoms like red eyes, lacrimation, and signs such as epibulbar hyperemia and tear insufficiency.
Signup and view all the answers
Restrictive myopathy in TED is caused by subsequent degeneration of muscle fibers leading to fibrosis.
Restrictive myopathy in TED is caused by subsequent degeneration of muscle fibers leading to fibrosis.
Signup and view all the answers
TED patients do not develop long-term ocular problems.
TED patients do not develop long-term ocular problems.
Signup and view all the answers
Thyroid Eye Disease does not proceed through congestive and fibrotic stages.
Thyroid Eye Disease does not proceed through congestive and fibrotic stages.
Signup and view all the answers
Study Notes
Thyroid Eye Disease: Clinical Features and Treatment
- Subsequent degeneration of muscle fibers leads to fibrosis, causing restrictive myopathy and diplopia.
- TED proceeds through congestive and fibrotic stages, with only 10% of patients developing long-term ocular problems.
- Clinical features include soft tissue involvement, lid retraction, proptosis, optic neuropathy, and restrictive myopathy.
- Soft tissue involvement presents with symptoms like red eyes, lacrimation, and signs such as epibulbar hyperemia and tear insufficiency.
- Lid retraction occurs in about 50% of patients and can result in a staring or bulging-eyed appearance.
- Proptosis can lead to exposure keratopathy and corneal ulceration.
- Between 30% and 50% of TED patients develop permanent ophthalmoplegia.
- Optic neuropathy, a serious complication, can cause severe visual impairment.
- Investigations include blood tests for thyroid disease and visual field testing for optic nerve compromise.
- Treatment includes cessation of smoking, management of thyroid dysfunction, and use of lubricants, topical anti-inflammatory agents, and systemic steroids.
- Mild disease treatment includes lubricants and topical anti-inflammatory agents.
- Moderate to severe active disease is treated with systemic steroids.
Thyroid Eye Disease: Clinical Features and Treatment
- Subsequent degeneration of muscle fibers leads to fibrosis, causing restrictive myopathy and diplopia.
- TED proceeds through congestive and fibrotic stages, with only 10% of patients developing long-term ocular problems.
- Clinical features include soft tissue involvement, lid retraction, proptosis, optic neuropathy, and restrictive myopathy.
- Soft tissue involvement presents with symptoms like red eyes, lacrimation, and signs such as epibulbar hyperemia and tear insufficiency.
- Lid retraction occurs in about 50% of patients and can result in a staring or bulging-eyed appearance.
- Proptosis can lead to exposure keratopathy and corneal ulceration.
- Between 30% and 50% of TED patients develop permanent ophthalmoplegia.
- Optic neuropathy, a serious complication, can cause severe visual impairment.
- Investigations include blood tests for thyroid disease and visual field testing for optic nerve compromise.
- Treatment includes cessation of smoking, management of thyroid dysfunction, and use of lubricants, topical anti-inflammatory agents, and systemic steroids.
- Mild disease treatment includes lubricants and topical anti-inflammatory agents.
- Moderate to severe active disease is treated with systemic steroids.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge of Thyroid Eye Disease (TED) with this quiz covering clinical features, complications, and treatment options. Learn about the stages of TED, ocular symptoms, and the various management strategies, from lifestyle changes to medical interventions.