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Thyroid Eye Disease

Thyroid Eye Disease: Pathogenesis and Clinical Findings Author: Liam Connors Reviewers: Lucy Yang, Mao Ding Julia Gospodinov Luiza Radu Samuel Fineblit* * MD at time of publication Environmental factors (smoking & stress, etc. mechanism unknown) Thyroid eye disease Genetic factors (mechanism unknown) An autoimmune condition wherein antibodies that target the thyroid & the periorbital tissues induce tissue swelling around the eye Auto-antibody production Type 1 insulin-like growth factor receptor (IGF-1, regulates cell growth) & thyroid stimulating hormone (TSH) receptor activation in CD34+ fibrocytes & orbital fibroblasts (cells part of the formation of connective tissue) Chemokine production (cells part of the inflammatory response) ↑ Immune response in the tissue around the eye (orbit) Fibrosis (overgrowth/scarring) & swelling of orbital tissues Eyelid retraction & lid lag on downward gaze ↑ Ocular surface exposure Corneal trauma, dryness, & microbe exposure Exposure keratopathy (corneal damage from ↑ exposure to air) Mechanical force causes eye misalignment Restrictive strabismus (both eyes do not line up in the same direction) Double vision Burning/foreign body sensation & epiphora (excess tears) Exophthalmos (bulging of one or both eyes) Mechanical strain on optic nerve Compressive optic neuropathy (damage to the optic nerve) Vision loss Afferent pupillary defect (altered pupil dilation) Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Oct 5, 2024 on www.thecalgaryguide.com