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Sight-Threatening Condition in Severe Thyroid Eye Disease: How We Should Manage
Yunia Irawati1, Dewi Megasari Juhrie, Carennia Paramita
1Plastic and Reconstructive Surgery Division, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.. yunia_irawati@yahoo.com.
Acta Medica Indonesiana
|April 10, 2022
Summary
This case report highlights managing sight-threatening thyroid eye disease (TED). Prompt diagnosis and adequate glucocorticoid treatment, alongside surgical interventions like fat decompression, are crucial for vision recovery.
Area of Science:
- Ophthalmology
- Endocrinology
- Autoimmune Disorders
Background:
- Thyroid eye disease (TED) is an autoimmune condition linked to thyroid dysfunction, causing orbital tissue enlargement.
- TED can lead to sight-threatening complications if not managed promptly.
Observation:
- A patient presented with vision loss and proptosis due to delayed TED diagnosis and inadequate initial steroid treatment.
- The patient initially refused orbital decompression but later underwent eyelid surgery (fat decompression and tarsorrhaphy).
Findings:
- Despite initial inadequate treatment, the patient achieved improved visual acuity and corneal health post-surgery.
- Fat decompression proved beneficial for visual acuity, even when orbital decompression was not feasible.
Implications:
- Effective TED management requires timely diagnosis and appropriate treatment, including adequate glucocorticoids and surgical options.
- Close collaboration between ophthalmologists and endocrinologists is essential for optimal patient outcomes in TED.
- Surgical interventions like fat decompression can significantly improve vision and prevent further complications in advanced TED cases.
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