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Thyroid Eye Disesase, patient information - University of Iowa TED is the most common cause of both orbital disease and exophthalmos (external protrusion of the eyeball from the socket) in North America and Europe TED occurs more frequently in women than in men, with both sexes having two age ranges in which TED is most likely to be diagnosed Females 16 per 100,000 (0 016%) females have TED
Treatment of Thyroid Eye Disease - University of Iowa TED is a self-limiting disease, with patients moving from the active to quiescent phase within 1-3 years with a 5-10% risk of recurrence [10] Treatment for TED should start at the time of the diagnosis, as treatment becomes less effective as the disease progresses from the early, acute, active phase to the chronic quiescent phase
Thyroid Eye Disease, workup and diagnosis - University of Iowa If TED is suspected, one must determine disease activity and severity in order to assess the urgency of treatment Disease Activity In assessing the activity level of TED in a patient, the clinical activity score (CAS) can be used [15] At the initial visit, patients are given a CAS score of 1-7, one point for each sign or symptom (Figure 19):
Thyroid Eye Disease, Presenting symptoms - University of Iowa TED is a self-limiting disease and may present in one of two stages: active or quiescent (Figure 6) In the active stage, there is active inflammation, which can lead to orbital muscle enlargement, conjunctival injection and chemosis, ocular pain, and swelling of the periocular tissues and eyelids
Thyroid Eye Disease- EyeRounds - University of Iowa TED is a self-limiting disease, with patients moving from the active to quiescent phase within 1-3 years with a 5-10% risk of recurrence Treatment for TED should start at the time of the diagnosis, as treatment becomes less effective as the disease progresses from the early, acute, active phase to the chronic quiescent phase
Treatment of Thyroid Eye Disease, continued - University of Iowa TED affects extraocular muscles in a predictable manner [39] The inferior rectus and medial rectus are most commonly involved This presents as hypotropia and or esotropia Most TED patients with diplopia due to strabismus will not require surgical intervention, as most can be effectively managed with prism spectacles [39]
Atlas Entry - Enlarged muscle bellies in thyroid eye disease The characteristic finding on CT scan is enlargement (due to inflammation and fibrosis) of the extraocular muscle bellies The muscle tendon is typically spared The muscles most commonly enlarged in TED are the inferior rectus followed by the medial rectus, although any of the muscles may be involved
Atlas Entry - Bilateral chemosis in thyroid eye disease Additional imaging and serology testing confirmed the diagnosis of thyroid eye disease (TED) In the early presentation of thyroid eye disease, patients may experience chemosis, conjunctival injection, and eyelid swelling secondary to orbital congestion For more information on TED, see the EyeRounds TED tutorial