Endocrine ophthalmopathy (literally "eye pain") is an eye disease that manifests itself in about 50% of all cases of increased thyroid activity. Until recently, this condition was called endocrine orbitopathy and was considered one of the symptoms of Graves' disease (thyrotoxicosis). However, as it turned out, endocrine ophthalmopathy can manifest itself as an independent disease (even when the function of the thyroid gland is not violated). The main symptom of this disease is a strongly pronounced exophthalmos (pop-eyed). With endocrine ophthalmopathy, the tissue behind the eyeball thickens, causing it to protrude. In this regard, a person rarely blinks, he has pain in his eyes, and in the worst case - paralysis of the oculomotor muscles or blindness. Many disorders (lachrymation, dryness or inflammation of the cornea - keratitis) arise from the inability of a person to close eyelids.
Symptoms of endocrine ophthalmopathy
- Inflammation of the connective membrane of the eyes (conjunctivitis).
- Edema of the eyelids.
- Pain in the eyes.
- Rare blinking.
- Paralysis of the oculomotor muscles.
- Reduction of vision before its complete loss.
- Lack of continuity of the eyelids.
Causes of endocrine ophthalmopathy
The cause of endocrine ophthalmopathy remains unclear. It is only known that the basis of the disease is the formation of certain proteins (so-called antibodies), which, perhaps, contribute to the "swelling" of the tissue located behind the eyeball. In addition, there is an opinion that the propensity to this disease is inherited.
Treatment of endocrine ophthalmopathy
The possibilities of treating this disease are very limited. It is mainly aimed at preventing more serious complications. It shows wearing glasses with darkened glasses, using special ointments.
In more severe cases, irradiation or even surgery to remove part of the thickened tissue behind the eyeball is performed. Sometimes, endocrine ophthalmopathy is prescribed glucocorticoids (hormones of the adrenal cortex).
The patient can only strictly follow all the doctor's instructions aimed at alleviating the symptoms of the disease.
Endocrine ophthalmopathy progresses very slowly - for several years. The appearance of early symptoms of this disease, such as pain behind the eyeball, eyelid edema, lachrymation or blistering, should be reported to your family doctor.
To clarify the diagnosis, the doctor will do a blood test. With the same purpose, hormones of the thyroid gland and specific antibodies are investigated. If the results of these studies confirm that the cause of these symptoms is endocrine ophthalmopathy, the family doctor will refer the patient to an ophthalmologist or endocrinologist.
Course of the disease
There are several stages of the disease, but only a few patients have all of its stages.
At first, the upper eyelid is lifted slightly, minor visual impairments appear. Then there is conjunctivitis (inflammation of the connective membrane of the eye), eyelid edema, lacrimation, photophobia, pain in the eyes.
In the future, the patient has ophthalmopathy, ocelliemia develops, visual acuity decreases, a veil appears before the eyes, weakness of oculomotor muscles may appear. At the last stage of the disease, the eye slits widen, and finally blindness occurs (due to damage to the optic nerves).
However, timely treatment of endocrine ophthalmopathy can stop the progression of the disease, and often even improve the patient's condition.
Usually, with ophthalmopathy, both eyes are affected. If only one eye is affected, a computed tomography scan should be performed to find out if there is a tumor behind the eyeball. The fact is that an erroneous diagnosis in the presence of a malignant tumor can lead to very serious consequences.