Ocular Manifestations in Patients with Thyroid Disorders Undergoing Thyroid Surgery

Abstract

Background: Thyroid disorders may be associated with a broad spectrum of ocular manifestations, ranging from dry eye and eyelid abnormalities to proptosis, diplopia and sight-threatening orbital complications. Early recognition of these manifestations is important for appropriate ophthalmic evaluation and management. The present study was undertaken to evaluate the frequency and spectrum of ocular manifestations among patients with thyroid disorders undergoing thyroid surgery and to assess their association with thyroid disorder type, thyroid hormone levels and duration of disease. Methods: A hospital-based cross-sectional observational study was conducted among 100 patients with thyroid disorders undergoing thyroid surgery at Index Medical College Hospital & Research Centre, Indore. Patients underwent detailed ophthalmic evaluation including assessment of visual acuity, ocular surface, eyelids, proptosis, ocular motility, diplopia, corneal involvement and optic nerve-related findings. Relevant clinical and biochemical parameters, including serum T3, T4 and TSH levels, were recorded. Associations between ocular manifestations and clinical variables were analyzed statistically. Results: The mean age of the study population was 42.8 ± 12.6 years, and 72% were female. Ocular manifestations were identified in 38% of patients. Dry eye or ocular surface symptoms were the most common finding (24%), followed by eyelid retraction (18%), lid lag (15%), conjunctival congestion (14%) and proptosis (13%). Ocular involvement was significantly associated with the type of thyroid disorder, being highest among patients with Graves’ disease (80%; p < 0.001). Patients with ocular manifestations had significantly higher T3 and T4 levels than those without ocular involvement (p = 0.012 and p = 0.008, respectively). Longer duration of thyroid disease was also significantly associated with ocular involvement (p = 0.040). Conclusion: Ocular manifestations were common among patients with thyroid disorders undergoing thyroid surgery, particularly those with Graves’ disease. Routine ophthalmic assessment may facilitate early recognition and appropriate management of thyroid-related ocular abnormalities.

Keywords: Thyroid disorders; Thyroid eye disease; Ocular manifestations; Graves’ disease; Proptosis