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COMMISSIONED ARTICLE
Year : 2015  |  Volume : 3  |  Issue : 2  |  Page : 113-119

An algorithmic approach in the diagnosis and management of thyroid eye disease


1 Consultant - Ophthalmic Plastic Surgery and Ocular Oncology, Advanced Eye Hospital and Institute, Navi Mumbai, India
2 Oculoplasty, Orbit, Ocular Oncology and Facial Aesthetics Surgeon, Consultant, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Correspondence Address:
Savari T Desai
P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai - 400 016, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3897.156625

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Thyroid eye disease (TED) or Graves ophthalmopathy is commonly associated with thyroid dysfunction and often causes a debilitating effect on the individual. Its presentations can result in misdiagnosis and often treatment is delayed in the initial acute inflammatory stages of the disease. The pathophysiology of this disease remains a complex process. The clinical examination, the activity and severity can help us decide the stage of the disease to help us formulate a management plan. The treatment strategy for TED is multi-pronged and consists of different modalities such as medical therapy, functional and cosmetic surgery and radiotherapy. Medical therapy ranges from supportive ocular surface protection and lubrication to potent immunosuppressive agents. Surgery, too can be vision-saving in severe dysthyroid optic neuropathy or exclusively cosmetic in cases of burnt-out orbitopathy. This review, discusses the examination, investigations of TED but essentially presents a step-by-step question based approach in the staging, diagnosis and management of thyroid eye disease.


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