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Thyroid Eye Disease 

Thyroid Eye Disease
Thyroid Eye Disease

Matthew J. Thurtell

, and Robert L. Tomsak

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date: 17 January 2021

Thyroid eye disease is the most common cause of orbital disease encountered in clinical practice. It most often occurs in patients with Graves disease, but can also occur in the absence of thyroid dysfunction. In this chapter, we begin by reviewing the clinical features and natural history of thyroid eye disease. We next discuss the diagnostic evaluation of thyroid eye disease, including the roles of imaging and visual field testing. We then briefly review the differential diagnosis, which includes idiopathic orbital inflammation, orbital cellulitis, and carotid-cavernous fistula. Lastly, we discuss the management approach for thyroid eye disease. Many patients have only mild disease and can be managed with supportive treatments, such as artificial tears, prisms, and selenium supplementation. However, patients with moderate to severe thyroid eye disease often require more aggressive treatments, such as immunosuppression with systemic corticosteroids, orbital irradiation, and orbital decompression surgery.

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