Hyperthyroidism exophthalmos is due to complications in the treatment of hyperthyroidism. It is characterized by exophthalmos. [1] Exophthalmos can be divided into non-invasive exophthalmos and invasive exophthalmos, also known as benign exophthalmos, which are more common and mostly bilateral. Ren's clinical manifestation is that his eyes are wide open and blink less, and when he stares down, he can't be coextensive with the eyeball because of the retraction of the upper eyelid. When the eyes look up, the forehead skin can't wrinkle the eyeball. Infiltrative exophthalmos, also known as endocrine exophthalmos, paralytic exophthalmos and malignant exophthalmos are rare, mostly bilateral. Compared with clinical manifestations, there are stinging pain, swelling and pain, foreign body sensation, even diplopia and decreased visual field. Exophthalmos is usually above 10 mm; Because the eyeball in Shanghai is highly prominent, the eyelid function can not close the bulbar conjunctiva, and the cornea is often exposed, so it is easy to be stimulated by the outside world, resulting in conjunctival congestion, edema, keratitis and corneal ulcer. Many people will cause panophthalmia and blindness. Ophthalmic process (7 photos)

Edit the classification of hyperthyroidism exophthalmos in this paragraph.

The most typical symptom of hyperthyroidism is exophthalmos, which can be divided into the following different types. The ocular symptoms of hyperthyroidism are mainly manifested as hyperthyroid exophthalmos, which can be divided into invasive and non-invasive ones. Noninvasive exophthalmos includes benign exophthalmos, false exophthalmos, nervous exophthalmos and dry exophthalmos. Exophthalmos are mostly below 18 mm and are generally symmetrical. Sometimes, one exophthalmos precedes the other, and the eyelid and extraocular parts mainly change, while the retrobulbar tissue has no obvious change, mainly due to the hyperactivity of sympathetic nerve and the increase of upper eyelid muscle tension. Invasive exophthalmos, also known as malignant exophthalmos, ophthalmoplegic exophthalmos, true exophthalmos and wet exophthalmos, is larger than 19-20 mm, which is caused by the enlargement of extraocular muscles and retrobulbar tissues and the infiltration of lymphocytes. Progressive bilateral or unilateral exophthalmos, which is rare in clinic, accounts for 6%- 10% of hyperthyroidism. There are more men with infiltrative exophthalmos than women, and women with non-infiltrative exophthalmos are several times more than men. Infiltrative exophthalmos is one of the special manifestations of diffuse goiter complicated with hyperthyroidism. At present, it is considered that it is related to autoimmune factors, and the onset is the joint action of cellular immunity and humoral immunity. The degree of exophthalmos has no obvious relationship with hyperthyroidism. The onset can be acute or slow. Typical patients are progressive bilateral or unilateral exophthalmos, which may be accompanied by swelling and pain of eyeball, tears and decreased vision. When the lesion involves the inferior rectus muscle of oculomotor nerve, the patient can't look up, when the medial rectus muscle is involved, it is accompanied by limited side view, and when the ophthalmoplegia occurs, diplopia can be seen, and even the eyeball can be fixed. There were orbital edema and conjunctival congestion during the examination. Contact with corneal field can cause corneal dryness, inflammation, ulcer and secondary infection, which can lead to optic atrophy and blindness in severe cases. Clinically, with the improvement of hyperthyroidism symptoms after treatment, exophthalmos can be improved in some patients, improved in some patients after hyperthyroidism treatment, and exophthalmos can be aggravated. Generally speaking, it is a natural course of disease from onset to stable and remission, usually 6 months to 3 years. Exophthalmos is the most serious within 4- 12 months after onset, and its development tends to stop on its own. Half of the patients 1 -3 years later, the symptoms of soft tissue involvement can be alleviated or disappeared, but exophthalmos rarely returns to normal, generally leaving a certain degree. Because the pathological changes of non-invasive exophthalmos are mainly the external changes of eyelids and eyes, patients are not suitable for polyocular diseases. The key to its onset is the tension of the upper and lower meibomian muscles and the fascia of the eyeball, which are dominated by sympathetic nerves, and the disharmony of the movement of the eyeball and eyelid. The main manifestations are: 1, the eyelid fissure is widened, and the number of blinks and stares is less; 2, eyeball inward polymerization can not or can not. 3. When the eyes look down, the upper eyelid cannot descend with the eyeball due to the tension of the upper eyelid plate muscle, thus exposing a certain range of sclera (white eyes) of the upper cornea. 4. When the eyes look up, the forehead skin can't be lifted.

Edit the cause of hyperthyroidism exophthalmos in this paragraph.

The main cause of simple exophthalmos is sympathetic nerve excitation, and the tension of extraocular muscle and levator palpebrae superioris muscle is increased by the action of thyroid hormone. In addition to the above reasons, the orbital soft tissue swells and proliferates, and the eye muscles are obviously diseased, which makes the eyeball protrude and the activity is limited. Patients often have intraocular foreign body sensation, eye pain, photophobia, tears, diplopia, strabismus, decreased vision and decreased vision. In severe cases, eyeball fixation, corneal ulcer or panophthalmia may occur, and even blindness may occur.

Edit the performance of hyperthyroidism exophthalmos in this paragraph.

The eyeball protrudes forward, the exophthalmos generally does not exceed 18 mm, and blinking (blinking) is reduced. The upper eyelid is contracture and the eye fissure is wide. When looking forward, the upper edge of the cornea is exposed (white eyes are exposed above the eyes). When looking down, the upper eyelid cannot fall or lag with the eyeball. When looking up, there should be no wrinkles on the forehead skin (no forehead lines). When your eyes are close to something, they don't converge well (you can't "look into your eyes"). Infiltrative exophthalmos is rare and mostly occurs in adult patients. In addition to the above eye signs, it is often accompanied by eyelid swelling and conjunctival congestion and edema.

Edit the treatment of exophthalmos in this paragraph.

Corticosteroids, such as prednisone, are most commonly used in clinical treatment of exophthalmos, with definite curative effect, convenient use and low price. But the effect is slow, the course of disease is long and there are many side effects. Other immunosuppressants, such as cyclosporine A, cyclophosphamide, etc., have certain curative effects, but have great side effects. Other methods, such as radiotherapy for severe exophthalmos, blood exchange therapy, and even surgical treatment, are not very certain. Others treated with Yunke can improve some symptoms and have no obvious effect on exophthalmos. In fact, TCM syndrome differentiation treatment of hyperthyroidism has few side effects and the curative effect is worthy of recognition.