This protocol covers factitious hyperthyroidism in patients who develop sight-threatening thyroid eye disease — specifically dysthyroid optic neuropathy and/or corneal breakdown. Both complications place the patient's vision at immediate risk.
Sight-threatening thyroid eye disease constitutes a clinical emergency because of the risk of sight loss due to dysthyroid optic neuropathy and/or corneal breakdown. The urgency of intervention is determined by the severity of ophthalmic deterioration.
Management of this emergency centres on an urgent surgical intervention involving the orbit. The complete clinical pathway, escalation criteria, and structured regimen are available in full below.
DOI: 10.1089/thy.2016.0229
It is an emergency because of the risk of sight loss due to dysthyroid optic neuropathy and/or corneal breakdown.
If there is no or inadequate response or deterioration of ophthalmic signs after 2 weeks of treatment, urgent orbital decompression surgery should be undertaken.
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