Conservative Management Options for Thyroid Disease Induced Diplopia
Authors:
M. Karhanová 1; J. Kalitová 1; O. Vláčil 1; L. Maliňáková 2; L. Drongová 2
Authors‘ workplace:
Oční klinika LF UP a FN, Olomouc, přednosta prof. MUDr. Jiří Řehák, CSc., FEBO
1; Optika – zdravotnické potřeby FN, Olomouc
2
Published in:
Čes. a slov. Oftal., 69, 2013, No. 5, p. 220-224
Category:
Original Article
Overview
Aim:
To focus on the conservative management options for diplopia in patients with thyroid ophthalmopathy in the active and in the “wait-for-operation” stage of the disease. To evaluate the degree of patient knowledge about the treatment options for diplopia and about different types of occlusion. To identify patient preferences when selecting from various management options.
Materials and methods:
This prospective study included patients with thyroid ophthalmopathy and disturbing diplopia in the primary gaze position who were referred for further treatment at the Department of Ophthalmology from January 2010 to June 2012. Twenty five patients (16 women and 9 men) were included for this study during the observation period. At the beginning, the degree of patient knowledge about the treatment options for diplopia and about different types of occlusion was assessed. Subsequently, all patients were informed in detail about different types of black and semi-translucent occlusion. After stabilization of diplopia, Fresnel prism and prism spectacle glasses were tested. At follow-up visits, patient preferences were evaluated.
Results:
Twenty patients were initially informed about monocular patching options by their doctor. Only twelve patients received more specific recommendations on how to cover the eye; in all cases non-translucent plastic or tape patch was recommended. Only one patient used non-translucent occlusion in daily life; ten patients used it occasionally during static activities. None of the patients was informed about semi-translucent occlusion possibilities. At follow-up after two to four months, 19 patients used semi-translucent occlusion in daily life (18 used semi-translucent tape, one used frosted lens). Only one patient continued to use non-translucent occlusion. Five patients used no occlusion and closed one eye when necessary.
Conclusion:
Strabismus surgery in patients with thyroid ophthalmopathy is recommended in the inactive phase of the disease. For patients with diplopia it could be very difficult to overcome the active phase of the disease. In our study, the vast majority of patients in this phase preferred semi-translucent occlusion to non-translucent one.
Key words:
diplopia, restrictive strabismus, thyroid ophthalmopathy, occlusion
Sources
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Labels
OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2013 Issue 5
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