Ögonförändringar vid hypertyreos (endokrin oftalmopati)
Senast uppdaterad: Senast reviderad:
Sakkunnig:Anders Behndig
Definition:
Ögonförändringar vid hypertyreos
Förekomst:
Prevalens av ögonsymtom vid Graves sjukdom är 25-50 %
Symtom:
Tillståndet är obehagligt, smärtsamt, kosmetiskt störande och kan i ovanliga fall hota synen
Kliniska fynd:
Exoftalmus, ofta asymmetrisk, ibland ensidig. Ögonlocksretraktion, där hornhinnans övre kant är synlig och övre ögonlocket inte följer med när patienten tittar ned. Svullnad och rodnad i konjunktiva.
Diagnostik:
Typisk anamnes och kliniska fynd. FT4, FT3, TSH, TRAk och anti-TPO. Ögonundersökning. CT eller MR differentierar mellan endokrin oftalmopati och tumör i ögonhålan
Behandling:
Behandla hypertyreosen . De flesta patienter har lindriga ögonförändringar som endast kräver symtomatisk behandling. Höga steroiddoser, strålbehandling eller kirurgi kan vara aktuellt i vissa fall
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- Anders Behndig, professor och överläkare, Ögonkliniken, Norrlands universitetssjukhus, Umeå
- Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet