Smoking and Strabismus Surgery in Patients with Thyroid Eye Disease

Rajendram, Rathie; Bunce, Catey; Adams, Gillian; Dayan, Colin; Rose, Geoffrey E.

doi:10.1016/j.ophtha.2011.06.003

Cited by 36 publications

(20 citation statements)

References 15 publications

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“…Patients should be advised to stop smoking; smokers with TED are twice as likely to need strabismus surgery. 5 Systemic steroids are prescribed with or without additional immunosuppression in the form of Azathiaprine or Cyclosporin or lowdose radiotherapy. Biological agents, such as Rituximab, are now sometimes employed and there is some evidence that cyclo-oxygenase inhibitors, such as Indomethacin, may be effective.…”

Section: Clinical Assessment and Non-surgical Managementmentioning

confidence: 99%

Management of strabismus in thyroid eye disease

Harrad

2014

Eye

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Thyroid eye disease is an auto-immune condition characterised by an acute inflammatory phase followed by a fibrotic phase, which sometimes leads to restricted eye movements and diplopia. Medical treatment with systemic steroids with or without orbital radiotherapy and immunosuppression can control the inflammatory response. Strabismus surgery should be carried out only after the inflammation is no longer active and after any decompression surgery. Surgery comprises recession of tight muscles using adjustable sutures so as to maximise the area of binocular single vision. There is debate as to whether adjustable sutures should be used for the inferior rectus muscle. Patients should be encouraged to have realistic expectations, as binocular single vision may not be achievable in all directions of gaze and lid retraction may be made worse by surgery.

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Section: Clinical Assessment and Non-surgical Managementmentioning

confidence: 99%

Management of strabismus in thyroid eye disease

Harrad

2014

Eye

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“…[22][23][24][25][26][27][28][29][30] When there are restricted muscles in both eyes, the underlying principle of the prism and cover test is not applicable because the yoke muscle response during fi xation is blocked by mechanical forces imposed by restricted muscles. Gradual divergence of the eyes over time eventually results in a large exotropia with limitation of adduction.…”

Section: Illustrative Casesmentioning

confidence: 99%

Restrictive Strabismus: Diagnosis and Management

Flanders

2014

American Orthoptic Journal

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The clinical spectrum of either purely or partially restrictive strabismus is very broad. The clinical evaluation of patients with this problem must include a careful and detailed history, which is crucial to establishing the diagnosis and must also explore the patient's concerns. Analysis of fixation, head posture, and ocular alignment require both traditional and special examination techniques. Patient and surgeon expectations must be synchronized preoperatively. A variety of surgical strategies can be applied to improve head posture, eliminate diplopia, and improve cosmesis.

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“…9,10 The prevalence of strabismus ranges from less than 0.5% to about 5% in different communities and countries. 6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] However, the prevalence is substantially higher in some diseases, such as Down or Marfan syndrome. 21,26 Available population-based studies on strabismus have mostly addressed binocular vision problems besides amblyopia and very few studies have exclusively evaluated strabismus.…”

Section: Introductionmentioning

confidence: 99%

“…21,26 Available population-based studies on strabismus have mostly addressed binocular vision problems besides amblyopia and very few studies have exclusively evaluated strabismus. 6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] One of the most important questions about strabismus is the ratio of esotropia to exotropia, which is different in different countries. Although most studies have reported that esotropia is more prevalent, most strabismic patients have exotropia in East Asian countries.…”

Section: Introductionmentioning

confidence: 99%