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No light perception vision from compressive thyroid orbitopathy.

Dana M Hornbeak¹, Madhura A Tamhankar, Lauren A Eckstein

¹Department of Ophthalmology, Scheie Eye Institute , Philadelphia, Pennsylvania , USA and.

Orbit (Amsterdam, Netherlands)

|November 12, 2013

Summary

This summary is machine-generated.

Thyroid eye disease (TED) can cause vision loss. This case report details a rare instance of rapid, severe vision loss to no light perception in a patient with TED and proptosis.

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Area of Science:

Ophthalmology
Endocrinology
Autoimmune diseases

Background:

Thyroid eye disease (TED) is an autoimmune disorder affecting eye tissues, leading to symptoms like eyelid retraction and proptosis.
Compressive optic neuropathy occurs in less than 5% of TED patients, typically within 18 months of hyperthyroidism diagnosis.
Vision loss in TED is usually gradual, bilateral, and associated with double vision and increased intraocular pressure.

Observation:

A 66-year-old male with long-standing TED and significant proptosis experienced rapid vision deterioration.
The patient's condition progressed from mild compressive symptoms to no light perception within days.
This acute vision loss occurred despite a 10-year period of clinical stability.

Findings:

This case represents the first reported instance of acute vision loss to no light perception secondary to thyroid orbitopathy.
The rapid progression to complete vision loss is highly unusual for compressive optic neuropathy in TED.
The patient's history of massive proptosis and prior stability makes this presentation unique.

Implications:

Highlights the potential for rapid, severe vision loss in TED, even after long periods of stability.
Underscores the need for vigilant monitoring of TED patients, particularly those with significant proptosis.
Suggests a need to investigate potential triggers or mechanisms for acute vision loss in thyroid orbitopathy.