Thyroid associated ophthalmopathy.

José Luís Metello, Margarita González, Rosário Eusébio, Vítor Rocha


Thyroid associated ophthalmopathy is an uncommon disease, characterized by a diffuse inflammation of the orbit in a bilateral and asymmetric pattern, causing proptosis and swelling of the eyelids and conjuntiva. In 90% of the patients it is associated with Graves' disease, however it may occur with hipothyroidism or even without thyroid disease. During its course spontaneous remission or exacerbations are common, evolving independently from the thyroid disease, most often without serious complications for the patient, being blindness the worse of them, in 1% of the cases. The cause is still misunderstood but it is thought to be the result of an immune system disorder with the production of auto-antibodies directed against retro-bulbar fibroblasts and thyroid. Therapeutics is still a controversial matter. The balance between benefits and medication adverse effects is still to be made.

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