True statement about dysthyroid eye disease (grave's opthalmopathy) is
C. i.e. Extreme exopthalmos is usually seen in hypothyroidism A mild exopthalmos is associated with thyrotoxicosis and an extreme exopthalmos may be associated with any state of thyroid activity, but usually in hypothyroidism often after thyroidectomy.Q Dysthyroid / Graves-Opthalmopathy or Endocrine / Malignant-Exopthalmos * Etiology Clinical Features Treatment Autoimmune in General (Thyrotoxicosis) Ocular * GuanethidineQ may which there is * SymptomsQ * Dalrympe's Sign- decrease lid antibody - Tiredness Retraction of upper eye lid producing Staring retraction caused by mediated attack - Emotional lability & Frightened appearanceQ over.action of on orbital - Heat intolerance Mn-"D for Dar" muller's muscleQ fibroblast - Weight loss * Von Graefe's Sign- * Systemic Steroids & primarily, extraocular - Excessive appetite - Palpitation Lid lag i.e on looking downwardsQ (towards Ground) upperlid follows tardily or not at all Radiotherapy (if steroids not muscles being * SignsQ Mn-"Graefe-Lid lag on looking Ground" effective) 1000 rad secondarily - Tachycardia (persist during * Stellwag's Sign- from each lateral involvedQ sleep)Q Infrequent blinking with deficient closure of po for reducing * Pathology - Hot, moist palms lidsQ orbital edema Mononuclear cell - Agitation Mn-"S for Still" * Aificial tears & inflammation - Thyroid goiter & bruit * IVRibius Sign- Lateral with presence of - Myopathy of proximal Decreased power of convergenceQ tarsorrhaphy to mucopolysacchri muscles Mn- "M for On looking Medially" prevent exposure des * Stages of development of * Enroth's Sign- keratopathy predominantly cardiac arrhythmias Fullness of eylids d/1 puffy Edematous * Prismatic glasses for hyluronic acid - Tachycardia which persist swelling diplopia together with during sleep Mn- "E for Edematous lid" * Orbital Interstial edema (characteristic)Q * Gifford's Sign- decompression & inflamatory - Multiple extra systole Difficulty in eversion of upper lid When steroid & cells - Paroxysmal atrial * Exopthalmos (Proptosis) have proved tachycardia * Weakness of extraocular muscles paicularly ineffective two wall - Paroxysmal atrial elevators (inferior oblique)Q causing diplopia (orbital floor & fibrillation * Conjunctival injection over inseion of recti medial wall - Persistent atrial fibrillation * Increased intra ocular pressure removed) not responding to digoxin * Superior limbic keratopathy decompression is done 28) Grade 4 Extraocular muscle involvement Q (limitation of movement & diplopia) Grade 5 Corneal involvement (exposure keratitis) Grade 6 Loss of Sight (d/t optic nerve involvement with disc pallor or papilloedema & visual field defect) " v:shapes="_x0000_s1026">Graves opthalmopathy is most common cause of U/L or B/L proptosis in adults between age of 25-50 yearsQ Werner Classification reflect severity of opthalmopathy and is well known by acronym of NO SPECS. Grade 0 - No signs or symptoms Grade 1 - Only signs (lid retraction with or without lid lag Q & mild proptosis) Grade 2 - Soft tissue involvement (chemosis, grit, lacrimation, photophobia, lid or conjuctival swelling) Grade 3 Proptosis Q (minimal28) Grade 4 Extraocular muscle involvement Q (limitation of movement & diplopia) Grade 5 Corneal involvement (exposure keratitis) Grade 6 Loss of Sight (d/t optic nerve involvement with disc pallor or papilloedema & visual field defect)
Decreased power of divergence
Most common cause of U/L proptosis in
Extreme exopthalmos is usually seen in hypothyroidism
On looking upwards lower lid does not follow eye movements