"Big eyes" also have troubles
In modern people's aesthetics, many people like big eyes.
But a few days ago, a girl who was troubled by "big eyes" came to the ophthalmology clinic.
The girl's surname is Wang, 22 years old. She has noticed that her eyes have become enlarged in the past three months.
She was quite happy at first, but slowly, she found that her eyes were getting bigger and bigger, as wide as copper bells.
Moreover, when she looked in the mirror in the morning, she found that the whites of her upper and lower eyes were exposed, her eyes were red, and her eyelids were swollen.
So the doctor performed a thyroid function test on her and found that Xiao Wang had hyperthyroidism (hyperthyroidism for short).
The doctor further asked her to do an orbital CT, which was consistent with the diagnosis of thyroid eye disease.
Why does hyperthyroidism cause thyroid eye disease?
Can this disease be cured?
Are the eyes really getting bigger?
Thyroid eye disease is the most common orbital disease. It is an autoimmune disease that can occur at any age. The most obvious symptom is exophthalmos.
In addition to protruding eyeballs, the whites of the patient's upper and lower eyes are often exposed.
Normally, the upper eyelids of a normal person will cover a little of the dark eyeballs, and the lower eyelids will be just below the black eyeballs, and the whites of the upper and lower eyes will not be exposed.
However, in patients with thyroid eye disease, the upper eyelids move upward and the lower eyelids move downward, making it look like they are staring.
In addition, patients may also have swollen eyelids, inability to open their eyes, red eyes, watery eyes, fear of light, inability to look straight ahead with two black eyeballs at the same time, seeing one object as two, or even being unable to turn the eyeballs. Movement and other symptoms.
Although the eyes of patients with thyroid eye disease have become larger, they are not beautiful and the patients are in pain.
So some people say that thyroid eye disease is a "disfiguring disease".
Do patients with hyperthyroidism always have exophthalmos?
Thyroid eye disease and hyperthyroidism are both autoimmune diseases, which means the body attacks its own normal cells. Simply put, there is "internal strife" between cells.
The "weapons" of attack are some pathogenic autoantibodies.
These antibodies not only recognize thyroid tissue and cause thyroid disease, but they also travel to the orbit behind the eyeball, causing tissue proliferation and edema behind the eyeball.
When the orbit behind the eyeball cannot accommodate it, the eyeball can only be pushed forward, resulting in the symptom of "big eyes".
The alias of thyroid eye disease is hyperthyroidism and exophthalmos. As the name suggests, it is closely related to hyperthyroidism.
But not all patients with hyperthyroidism will suffer from hyperthyroidism and exophthalmos.
Among patients with thyroid eye disease, about 40% develop after hyperthyroidism, 40% of patients develop eye disease at the same time as hyperthyroidism, and about 20% of patients develop eye disease before hyperthyroidism.
In addition, some people with thyroid eye disease may also have chronic lymphocytic thyroiditis, hypothyroidism or even normal thyroid function.
Which groups are more susceptible to
Thyroid eye disease affects more women than men, and the severity of the condition increases with age.
Abnormal thyroid function, especially high and low thyroid function, will increase the risk of disease.
In addition, smoking is also an important risk factor. It can not only increase the incidence of thyroid eye disease, but also aggravate the condition. The amount of smoking per day is significantly related to the incidence of proptosis symptoms.
Some friends with hypercholesterolemia, selenium deficiency or vitamin D deficiency will also have a higher incidence of thyroid eye disease.
Multidisciplinary consultation is necessary
Severe thyroid eye disease may cause vision loss or even blindness.
In addition, corneal ulcers or even perforation may occur due to eyelid retraction, eyeball protrusion, and long-term exposure of the cornea to the outside.
Therefore, patients with thyroid eye disease should be actively treated.
If patients with thyroid disease experience eye discomfort, such as large, red eyes, etc., they should see an ophthalmologist as soon as possible.
If patients with thyroid eye disease also have hyperthyroidism, they need to see an endocrinologist to better control thyroid function. Sometimes doctors from general surgery and nuclear medicine departments also need to be diagnosed and treated together.
Therefore, it is recommended that patients go to a hospital that has established a multidisciplinary joint diagnosis and treatment clinic for thyroid eye disease, which will help formulate a systematic and comprehensive treatment plan.
In addition, it should also be noted that thyroid eye disease is a physical and mental disease. Some patients will have changes in appearance that affect their daily social life and life, thus affecting their mental health.
Therefore, if you are a family member of a patient with thyroid eye disease, you should pay more attention to the patient in your life and strengthen psychological counseling and monitoring.
Can thyroid eye disease be cured?
Different patients with thyroid eye disease have different symptoms and different treatment options.
Currently, treatments for thyroid eye disease include medication, radiation therapy, and surgery.
The basic strategy is to restore normal thyroid function as quickly as possible and maintain stability with the help of an endocrinologist.
If the patient has just started to suffer from the disease and the eye symptoms are not obvious yet, regular follow-up is usually enough after being evaluated by a doctor; if the disease suddenly progresses, immediate follow-up is required.
At the same time, during this process, maintaining stable thyroid function and developing habits according to the above-mentioned life suggestions can delay the development of the disease to a certain extent.
If the patient's eye symptoms such as red eyes and tearing are obvious, he can first receive treatment with hormones, targeted drugs, immunosuppressants, etc. For more severe cases, further treatment with local orbital radiation therapy is required.
If the patient's symptoms have basically stabilized, mainly because the eyes are large and the whites of the upper and lower eyes are exposed, which affects the appearance and quality of life, or the vision has declined severely, or other treatment options are ineffective, surgical treatment is required.
Doctors usually perform orbital decompression surgery first, and then, if necessary, perform strabismus correction surgery and eyelid correction surgery to comprehensively improve the condition.
It should be noted that if the proptosis has existed for a long time and is not treated in time in the early stage, the tissues in the orbit will gradually produce irreversible proliferation and fibrosis, and the only way to make the eyeball roll back is through surgery.
After the doctor's treatment, Xiao Wang's symptoms of proptosis were greatly reduced, and he no longer felt like staring at others.
Only then did she understand that pursuing "big eyes" was not necessarily a good thing. It might be thyroid eye disease.
This disease not only affects appearance but may also threaten vision.
Patients should do the following in their daily lives:
Source: Public Health Magazine
Author: Department of Ophthalmology, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Lei Chaoyu Zhou Huifang
Review: Experts from the National Health Science Popularization Expert Database
Chen Weirong, Professor of Zhongshan Ophthalmology Center, Sun Yat-sen University