-OD responsibility: low vision care, refer to retinal specialist, refer to nephrologist
What is Gigantism and Acromegaly?
-Hyperpituitarism in children and adults respectively
-Bi-termporal visual field loss intially, eventually all optic fibers are affected
Interpretation of a CT scan?
-Bone is white, soft tissues are grey, air is black
-useful for viewing bony detail and soft tissue in orbit
What is Graves' disease?
-autoimmune disease hyperthyroid disease, goiter
-Sxs: pain, diplopia, vision loss
-Thyroid-associated ophthalmopathy leading to fibrosis/scarring in 1-2 years (90% with TAO have Graves' disease), Optic neuropathy (compression and atrophy), Retinopathy (edema: retinal folds, hemorrhages)
-Progression: NO SPECS (No signs or Sxs, Only lid retraction, Soft tissue involvment, Proptosis (>20mm), EOM involvement, Corneal involvement, Sight loss)
-Tx: antithyroid drugs, surgery (subtotal thyroidectomy), radioactive iodine
What is the darymple sign?
wide palpebral fissure due to lid retraction in Graves' disease ophthalmopathy
What is the stellwag sign?
-infrequent blinking and staring expression in Graves' disease ophthalmopathy
What is the von Graefe sign?
-lid lag on donward gaze (80% of Graves' disease ophthalmopathy cases)