Thyroid status / thyroid eyes
Grave's eye disease
| Incidental findings | Pretibial myxoedema |
| +ve signs | Exopthalmos, chemosis, ophthalmoplegia, lid lag, diplopia |
| Differential diagnosis | See below |
| Function | ?Visual loss / exposure keratitis, ulceration |
| Tests |
TSH, fT4 Thyroid autoantibodies |
|
Unilateral proptosis Grave’s disease Retro-orbital tumour Orbital cellulitis |
Bilateral proptosis Grave’s disease Carvernous sinus thrombosis Caroto-cavernous fistula |
Thyoid status
| Incidental findings | |
| +ve signs |
Hyperthyroid: Tremor, thyroid acropachy, plummer’s nails, sweaty palms, tachycardia, AF, thyroid eye disease, pretibial myxoedema Hypothyroid: Bradycardia, carpal tunnel syndrome, dry skin, coarse facial features, loss outer third eyebrow, xanthelasma, slow relaxing reflexes |
| Differential diagnosis | See below |
| Function | |
| Tests |
TSH, fT4 Thyroid autoantibodies |
|
Hyperthyroidism Grave’s Toxic adenoma Toxic multinodular goitre De Quervains |
Hypothyroidism Autoimmune/Hashimotos Iatrogenic Iodine deficiency |
Notes
- Management severe Grave’s eye disease: Lubricating eye drops / Optimise thyroid status / Systemic steroids / radiotherapy / lateral tarsorraphy / orbital decompression