Thyroid ophthalmopathy

Thyroid ophthalmopathy, idiopathic orbital inflammation, and orbital infection can occasionally demonstrate overlapping clinical features. It is essential to distinguish between these processes because appropriate treatments are distinct in each case. In the past year, the pathophysiology of thyroid ophthalmopathy has been the topic of many reports. Orbital inflammation, particularly the fibrotic form, has been recognized to represent a distinct disease entity that may require more specifically directed treatment. In some cases cytotoxic therapies may be indicated. Orbital infection, particularly in the setting of orbital abscess, may be treated conservatively with antibiotic therapy and observation or more aggressively with surgical drainage procedures. In several recent studies, appropriate management of such infectious processes appears to be related to patient age, as well as to the specific clinical pattern of presentation.