The 57-year-old uncle developed “goldfish eyes”, which is related to the thyroid.


We have a magical organ in our body

It is very light and looks like a butterfly

It is the largest endocrine gland in adults

Speaking of its name, everyone is familiar with it


The thyroid hormone it secretes

Very important for nervous system development and bone development

In addition to common diseases such as thyroid nodules and thyroid cancer

Irregular thyroid function can also lead to eye disease

Reminder of ophthalmologists of the First Affiliated Hospital of Zhejiang University School of Medicine

In case of proptosis, swollen eyelids, double vision

Other symptoms, please seek medical attention in time


Eyes become goldfish eyes

This eye disease is thyroid-related

Uncle Zheng (pseudonym) from Huzhou is 57 years old this year. He has been suffering from hyperthyroidism for more than ten years. Although he has undergone drug control and iodine 131 treatment, he still has symptoms such as palpitation and thick neck. , the treatment effect is not ideal.

In recent years, Uncle Zheng also found that the eyeballs of his eyes kept bulging out like “goldfish eyes”, and double images began to appear when he saw things. “Everything you look at is repeated twice, even at traffic lights, but as long as you cover one eye, the double image disappears.” Uncle Zheng introduced that for this reason, he had to wear a pair of sunglasses to “cover the ugly” when he went out and walked. You must also be careful, for fear of stepping up and down the steps, and you have never driven by yourself since then.

A year ago, in order to treat hyperthyroidism, Uncle Zheng came to the Endocrinology Department of the First Hospital of Zhejiang University for further treatment. For the eye condition, he was recommended by the doctor to the Ophthalmology Department of the First Hospital of Zhejiang University.

“The physical examination revealed that in addition to proptosis and diplopia, he also had eye movement disorders, restricted strabismus, and a certain degree of compensatory head position, that is, head tilt.” According to Dr. Long Yan, the ophthalmologist who received the consultation, he was diagnosed with thyroid-related eye disease, which is an autoimmune disease in which the immune system attacks the eyes, and is often accompanied by the occurrence of thyroid disease. happen.

Schematic diagram of exophthalmos symptoms, Internet pictures, not related to this case

Because Uncle Zheng’s general condition was not suitable for surgery at that time, Dr. Long Yan gave him symptomatic treatment such as drugs, and at the same time told him to review regularly. In the past year, Uncle Zheng had his thyroid removed by surgery. At present, his thyroid function has been basically stable, but his eye condition has not improved. It is convenient for him to come to the Ophthalmology Department of the First Hospital of Zhejiang University again recently.

After the doctor’s evaluation, Uncle Zheng’s thyroid function has been stable for more than half a year, and the eye condition is also in the stable stage. Surgery can be considered for strabismus. A few days ago, Uncle Zheng has undergone eye surgery to solve the problem of strabismus and diplopia, and obtained satisfactory surgical results. He will be reviewed regularly in the future.


Browsing eyes, ghosting, head tilt…

These symptoms affect quality of life

Thyroid-related ophthalmopathy (TAO) is a complex orbital disease caused by multiple factors, ranking first in adult orbital diseases. The ratio was 3:16, of which TAO with hyperthyroidism accounted for about 90%. Although the incidence of the disease is low, the eyes are the only sense we use to observe the world. Even mild symptoms can affect the quality of life of patients, so they cannot be ignored.

Common symptoms of thyroid-related eye disease include:


Eyelid retraction, the most common first symptom, occurs in more than 70% of patients;


Proptosis, in severe cases, the eyeball may protrude more than 3 mm, and even develop into malignant proptosis, resulting in insufficiency of eyelid closure, corneal damage, etc., which seriously affects vision;


Diplopia, that is, there will be double vision when looking at things, which seriously affects daily life;


Squint, due to the long-term chronic inflammatory reaction of the extraocular muscles, resulting in muscle fibrosis, restrictive strabismus, and thus a tilted head, which seriously affects the appearance;


Optic neuropathy, due to long-term intraorbital soft tissue inflammation and edema, leads to increased intraorbital pressure, complicated by optic nerve edema or pallor, which seriously threatens vision.

Once thyroid-related eye disease occurs, it will have a certain impact on the daily life of patients, and ocular abnormalities do not completely follow the improvement of thyroid disease. Caused by long-term accompanying, early treatment can achieve better results.

Treatment for thyroid-related eye disease includes daily eye care, medications, radiation, surgery, and more. The main purpose of surgical treatment is to improve the patient’s ocular symptoms, protect vision and improve appearance, followed by orbital decompression, extraocular muscle surgery and eyelid retraction correction.

Thyroid-related eye disease can cause restrictive extraocular muscle dysfunction, leading to irreversible strabismus and diplopia, which seriously affects the quality of life of individuals. The restrictive strabismus caused by it is different from ordinary strabismus. The different degrees of fibrosis of the extraocular muscles greatly increase the difficulty of surgery, and the calculation of the amount of surgery is also different from conventional surgery. Serve.


Has a thyroid-related disorder

Pay attention to screening

Deputy chief physician Yang Chongqing, deputy director of the Department of Ophthalmology of the First Hospital of Zhejiang University, reminded that thyroid-related eye disease can occur in all age groups, most of which are women. According to the European EUGOGO guidelines, smoking will significantly increase the incidence of thyroid-related eye disease. morbidity, so patients with the disease should quit smoking.

He pointed out that proptosis and diplopia are common symptoms of thyroid-related eye disease. Patients may have photophobia, squinting, like to close one eye to see things, tilt their head to look at things, Or there are usually learning and living obstacles, poor eyesight, easy to see the wrong way, easy to fall when walking, etc. If you have abnormal thyroid function or other thyroid diseases and have eye-related symptoms at the same time, please go to the ophthalmology clinic for screening and diagnosis in time.

Expert Outpatient Arrangement of the First Hospital of Zhejiang University