In a recent cohort of 2,045 patients with Graves’ disease, the rates of NOSPECS classes IV-VI were 30.4% in men and 21.3% in women (32). Blurring of vision and diplopia are other symptoms. She had right eye proptosis and diplopia on vertical gaze but with no lid lag or retraction. Low dose radiotherapy (RT) has been reported with good results for the treatment of acute inflammation and CON in Graves’ ophthalmopathy. Thyroid eye disease (TED) is an autoimmune is an autoimmune disease caused by the activation of orbital fibroblasts by autoantibodies directed against thyroid receptors. Her intraocular pressures were normal and the optic discs were normal on fundoscopy. 9. All the latter patients had some mild thyroid abnormalities (thyroid autoantibodies, negative TRH test, negative T3 suppression test, goitre).
Her visual acuity was 5/6 in both the eyes. The presentation and management of endo crine ophthalmopathy. Sex distribution analysis evidenced a higher prevalence in females with a female/male ratio of 2.1 which was, however, significantly lower (P less than 0.05) than that observed in control (Graves' disease patients without overt ophthalmopathy (female/male ratio = 3.4].
Effects of Genetics and Sex . Eye disease was associated with hyperthyroidism in 202 of 221 patients with active Graves' ophthalmopathy (91.4%) and was not accompanied by thyroid hyperfunction (euthyroid Graves' disease) in the remaining 19 (8.6%). At this point, a differential diagnosis of right inferior rectus mass and thyroid eye disease was considered.Euthyroid Graves’ ophthalmopathy can present initially with negative thyroid-specific autoantibodies.CT orbit showing bilateral asymmetrical enlargement of the inferior rectus.Patient’s consent has been obtained for the publication of this case report.MRI orbit showing bilateral enlargement of inferior rectus and mild right-sided proptosis.The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.Reference ranges: FT4, 11.0–23.0 pmol/L; FT3, 2.67–7.03 pmol/L; TSH, 0.4–4.5 U/L; TRAbs <0.1 U/L.
The patient had a Free T4 of 4.7 nanograms/dL and TSH of 0.2 micro IU/mL.
About half of people with Graves' disease notice some eye issues, and some have severe vision problems. During the active disease phase, this can last from several months to 5 years or longer, symptoms typically wax and wane, sometimes worsening over time. It is also possible to have Graves’ ophthalmopathy without thyroid dysfunction which is called euthyroid Graves’ disease.Treatments for dry eyes associated with Graves’ disease include artificial tears, lubricants at night, and punctal plugs to prevent drying of the cornea and exposure keratopathy. Patients with suggestive symptoms of ophthalmopathy should be carefully evaluated for GO with imaging studies even when thyroid function and autoantibodies are normal.This work did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.A 66-year-old female presented with a 4-month history of double vision, excessive tearing, sticky feeling in the eyes, and orbital pain in all gaze directions.