Thyroid Associated Ophthalmopathy – A Review

  • Mallika PS
  • AK Tan
  • Aziz S
  • Syed Alwi SAR
  • MS Chong
  • Vanitha R
  • Intan G
Keywords: Thyroid eye disease, autoimmunity, smoking, corticosteroids, radiotherapy, surgical decompression, rehabilitative surgery


Thyroid associated ophthalmopathy is an autoimmune disorder affecting the orbital and periorbital tissues. Hyperthyroidismis commonly associated with thyroid associated ophthalmopathy, however in 5% to 10% of cases it is euthyroid. Genetic,environmental and endogenous factors play a role in the initiation of the thyroid ophthalmopathy. Smoking has been identifiedas the strongest risk factor for the development of the disorder. The pathogenesis involves activation of both humoral and cellmediated immunity with subsequent production of gycoaminoglycans, hyaluronic acid resulting in oedema formation, increaseextraocular mass and adipogenesis in the orbit. The natural history of the disease progresses from active to inactive fibroticstage over a period of years. Diagnosis is mainly clinical and almost all patients with ophthalmopathy exhibit some form ofthyroid abnormality on further testing. Treatment is based on the clinical severity of the disease. Non-severe cases aremanaged by supportive measures to reduce the symptomatology and severe cases are treated by either medical or surgicaldecompression. Rehabilitative surgery is done for quiescent disease to reduce diplopia and improve cosmesis.


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How to Cite
PSM., TanA., SA., SARS. A., ChongM., RV., & GI. (2009). Thyroid Associated Ophthalmopathy – A Review. Malaysian Family Physician, 4(1), 7. Retrieved from
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