Qamar Farooq.
Dysthyroid Orbitopathies.
Pak J Ophthalmol Jan ;16(3):104-9.

Purpose: The study was designed to see the rates of various orbitopathies in thyrotoxicosis. NOSPECS classification system was followed. Study Design: It was a multicentric simple cross-sectional study upon the new and old cases of thyrotoxicosis visiting randomly three different centers of twin cities (Rawalpindi and Islamabad) for diagnosis, treatment and follow-up, including all ages and both sexes. Materials and Methods: Study population was 42 patients of thyrotoxicosis intersected at 1) Eye department of Rawalpindi General Hospital (RGH), ii) Internal Medicine department of Pakistan Institute of Medical Sciences (PIMS), Islamabad and III) Nuclear Medicine Oncology and Radiology Institute (NORI), Islamabad. Each patient underwent a complete ocular examination including slit-lamp examination, tonometry, funduscopy, color vision and measurement of proptosis by Hertel`s exophthalmometer. NOSPECS classification was followed and every patient was categorized accordingly. Various signs of the disease were looked for and their rates calculated. Results: In this study of 42 thyrotoxic patients from the three centers, 34 patients (81%) showed some sort of orbitopathy at the time of examination. Age range of the patients was 16 to 80 years with a mean of 36.88 years. Age distribution of the patients was bimodal showing higher numbers in 21 to 30 years and 41 to 50 years. Orbitopathy of low index was seen more commonly (67%) as compared to high index (14%). High index orbitopathy is more common in males and in older age groups. Of the various lid signs Kocher`s, Dalrymple`s, and von Graefe`s were the most common. Proptosis of 3mm or more was encountered in 12% and diplopla from restrictive myopathy in 7% of the thyrotoxic patients. Optic nerve compression was present in 3 out of 42 (7%). Complete constellation of the disease was seen in 144.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com