Thyroid-associated eye disease in patients with thyroid disease attending thyroid clinic at the Kenyatta National Hospital

Abstract

The aim of this study was to determine the epidemiology of TAED, its manifestations, complications and treatment as seen in KNH. It was a cross-sectional study conducted in patients attending the thyroid clinic of KNH. Data was analyzed using SPSS version 10. A total of III Africans of Kenyan origin were examined. 103 of them were females and 8 were males. The age range was from 7 to 80 years. TAED was present in 64 of 111 patients giving a prevalence of 58%. Eighteen of them had had thyroidectomy and 29 were on antithyroid drugs. Fifty seven (89%) of patients were diagnosed to have thyroid disease in the medical clinic, but 7 (11%) of them first presented to the eye clinic with symptoms attributable to TAED and were then referred to the physician. Eleven (17%) had severe form of the disease while 53 (83%) had nonsevere disease. Only 7 of the patients who had severe disease had active disease. Sixty two (97%) patients had bilateral disease and only 2 (3%) had unilateral disease. The common presenting complaints were redness and foreign body sensation. Most of the patients had multiple complaints. Five patients complained of double vision. The most common signs were conjuctival injection, lid retraction and proptosis in that order. Two patients had constant diplopia and one of them had a chin lift. Five patients had exposure keratitis due to marked proptosis. Three patients were found to have optic

atrophy but no patient had choroidal striae. One patient was found to have hypertensive retinopathy grade two. 22 patients were on various treatments for TAED. Sixteen patients were on topical steroids. One patient was on patching therapy for diplopia while another had tarrsorhaphy to prevent exposure keratopathy. Two patients were on artificial tears for dry eyes and exposure keratopathy. No patient had decompression, radiotherapy or extraocular muscle surgery done.