title: No light perception vision from compressive thyroid orbitopathy.
abstract: Thyroid eye disease (TED) is an autoimmune inflammatory disorder that affects the extraocular soft tissues and causes eyelid retraction, proptosis and restrictive extraocular myopathy. Compressive optic neuropathy from extraocular muscle enlargement occurs in less than 5% of patients, in the majority of whom it develops within 18 months of the diagnosis of hyperthyroidism. Vision loss from compressive optic neuropathy in patients with thyroid eye disease is usually bilateral and insidious in onset and progression and is associated with diplopia and elevated intraocular pressure. To our knowledge, there have been no reported cases of acute vision loss to the level of no light perception secondary to thyroid orbitopathy. The authors report a 66-year-old Caucasian male with history of long-standing thyroid eye disease and massive proptosis who progressed from mild compressive symptoms to no light perception within days, despite being clinically stable for over 10 years.
authors.affiliation: Department of Ophthalmology, Scheie Eye Institute , Philadelphia, Pennsylvania , USA and.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hornbeak
authors.forename: Madhura A
authors.initials: MA
authors.lastname: Tamhankar
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Eckstein
mesh_terms: D000368:Aged; D001766:Blindness / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D005094:Exophthalmos / Q000175:diagnosis / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D049970:Graves Ophthalmopathy / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D006984:Hypertrophy; D007262:Infusions, Intravenous; D018810:Magnetic Resonance Angiography; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009801:Oculomotor Muscles / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone