Sight threatening TED are those patients who have dysthyroid
optic neuropathy or corneal breakdown.
4) Advanced age, systemic vascular disease, hyperviscosity, diabetes mellitus, dysthyroid
ophthalmopathy, and 360[degrees] scleral buckling surgery due to retinal detachment are among the risk factors associated with this complication.
Unilateral eyelid retraction secondary to contralateral ptosis in dysthyroid
Included in the differential diagnoses are dysthyroid
eye disease, retrobulbar orbital tumor, inflammatory pseudo tumor, sinus tumor, metastatic lesion and mucoceles of paranasal sinuses.
Along its path it can become compressed, inflamed, ischaemic or mechanically stretched by the abnormally enlarged surrounding extraocular muscles and orbital tissues leading to dysthyroid
optic neuropathy (DON).
Two of the six patients had dysthyroid optic neuropathy; one proved refractory to intravenous methylprednisolone and the other worsened despite orbital decompression surgery.
One patient with dysthyroid optic neuropathy experienced an almost immediate, significant improvement in visual acuity; within 10 days of the first infusion, this patient's vision went from perception of light only to 6/18, a metric rating that corresponds to 20/60 on the visual acuity scale.
Thomas SM, Cruz OA 2007 Comparison of two different surgical techniques for the treatment of strabismus in dysthyroid
ophthalmopathy Journal of the American Association for Pediatric Ophthalmology and Strabismus 11 258-261
Botulinum toxin type a for dysthyroid upper eyelid retraction.
Botulinum toxin treatment for crocodile tears, spastic entropion and for dysthyroid upper eyelid retraction].
A wide variety of problems can cause damage in these areas, including compressions due to arterial-venous malformations (carotid artery aneurysm, cavernous sinus thrombosis or fistula), tumours (pituitary adenoma, naso-pharyngeal carcinoma, meningioma, metastases), and inflammatory disorders (orbital cellulitis, dysthyroid
eye disease, non-specific granulomatous masses associated with Tolosa-Hunt syndrome).
Examples include entrapment of an EOM due to a blow out fracture, dysthyroid
eye disease and ocular myositis.