Uniocular thyroid orbitopathy

Abstract

<br>Thyroid associated orbitopathy is used to describe the ocular manifestations of thyroid eye disease. The pathogenesis of the disorder is poorly understood. Considered to be an ophthalmic auto immune disease, it is usually associated with hyperthyroidism, and may occur in euthyroid as well as in hypothyroid individuals. It also can occur with Hashimoto Thyroiditis .The manifestations are usually bilateral or may start as unilateral and later progress to bilateral. These can present as exophthalmos or lid retraction or a combination of both or inflammatory reaction with conjunctival congestion. Decreased vision can occur either due to optic nerve compression, by crowding of the apex of orbit by enlarged extra ocular muscles and increase in volume of fibro fatty tissue or exposure keratitis. Enlargement of extra ocular muscles with restriction of movements can also lead to diplopia. Among patients with Thyroid Associated Orbitopathy, approximately 90% have Graves' hyperthyroidism, 1% have primary hypothyroidism, 3% have Hashimoto thyroiditis and 6% are Euthyroid. This is a report of cases either with uniocular exophthalmos alone or isolated lid retraction only. Surgical correction was performed in these patients due to cosmetic disfigurement and psycho-social problems.<br>