Dysthyroid Eye Disease from the Inside Looking Out

Carolyn Calcutt, D.B.O.(D)

The actual incidence of Dysthyroid eye disease or thyroid ophthalmopathy in thyroid dysfunction is probably not known, as not all patients with thyroid disease are referred to endocrinologists or other hospital physicians, but are managed by their General Practitioner. Also endocrinologists tend to apply variable criteria for referral to an ophthalmologist. Some only consider ophthalmic opinion when there is obvious thyroid ophthalmopathy with serious visual disturbance, diplopia in the primary position or marked exophthalmos, and others will request ophthalmic advice when there is only minimal evidence of Dysthyroid eye disease. It is possible therefore that some patients with thyroid eye disease may remain undiagnosed and untreated.

This paper discusses the author’s own experience of thyrotoxicosis and thyroid ophthalmopathy particularly with regard to the understanding of the general disease process, the cause of some of the signs such as excessive blinking, lacrimation and adoption of abnormal head posture; and the importance of the right psychological approach to the management of some of the more unsightly cosmetic problems.