Thyroid ophthalmopathy refers to thyroid-associated ophthalmopathy (TAO), also known as Graves’ ophthalmopathy.Its manifestations include ocular symptoms (e.g., photophobia, lacrimation) and systemic symptoms (e.g., irritability, tachycardia).
- Ocular Symptoms
In patients with thyroid-associated ophthalmopathy, infiltration of retro-orbital T lymphocytes stimulates retro-orbital fibroblasts to secrete large amounts of glycosaminoglycans.Deposition of these substances in tissues leads to increased hyaluronic acid, resulting in swelling and injury of extraocular muscles or orbital fat, which causes exophthalmos.
This is accompanied by: foreign body sensation, ocular distending pain, photophobia, lacrimation, diplopia, strabismus, and decreased visual acuity.Clinical examination may reveal eyelid swelling, conjunctival congestion and edema, and restricted ocular motility; in severe cases, the eyeball becomes fixed.
Some critically ill patients may develop incomplete eyelid closure with corneal exposure, leading to corneal ulceration and even panophthalmitis. - Systemic Symptoms
Most patients with thyroid-associated ophthalmopathy have coexisting hyperthyroidism.Dysfunction of the thyroid gland disrupts the endocrine system, commonly causing:irritability, weight loss, increased appetite, tachycardia, and hyperhidrosis.