One day, a [strange] patient came to the clinic: He is tall and gentle, but he wears a pair of swimming glasses. After taking off the glasses, I saw a pair of bloodshot, [glaring eyes] eyes. He said that he had hyperthyroidism three years ago, and his eyes gradually protruded. Even his sleeping eyes could not be closed. His eyes were dry and severe, so he could only wear swimming glasses to solve it.
He was diagnosed with thyroid-associated ophthalmopathy, I thought I only needed to treat hyperthyroidism, But I didn’t expect his protruding eyes to bring greater influence to his life. Originally, he was sunny and handsome and aged a lot. The character also became withdrawn. I lost my job, The wife ran away, No friends, Now I am simply [miserable]. [miserable]-I never thought patients with thyroid-related eye diseases would use these four words to describe their lives before, After all, compared with life-threatening diseases such as tumors and coronary heart disease, It is too easy to be ignored. There are still many patients like [Brother Glasses]. Some relatives and friends do not recognize themselves after the illness, and some even dare not take photos for several years. Their experience has made me realize that thyroid-related eye disease is not a trivial disease, and its treatment does not happen overnight. Thyroid-related eye disease is what? Thyroid-associated ophthalmopathy is also called Grave’s ophthalmopathy, It is an autoimmune disease, It is also the most common orbital disease in adults. The human immune system is like an army. 24 hours to protect the health of the body, Resist the invasion of harmful substances, When the immune system is abnormal, It is possible to produce antibodies, Attacks normal cells in your body, Occurrence of autoimmune diseases. Thyroid-related ophthalmopathy is such a kind of disease. Due to the immunological similarities between thyroid gland and orbital tissue, thyroid gland and orbital tissue are attacked by autoantibodies at the same time, which not only causes thyroid abnormalities, but also causes various eye problems. Is there a clinical manifestation of what? The eyes of a man are like a room, The four walls are the orbital wall. There are eyeballs, nerves, muscles and fat in the room. Under the influence of abnormal immune function, The muscle and fat in the orbit change, As that volume increase, Compressing the eyeball and nerves. Due to the limited space in the orbit, The rooms became more and more crowded, In order to improve [housing conditions], Only [illegal structures] can be built outside the house, So there is exophthalmos, eyelid retraction, eyeball movement disorders. More than 70% of the patients first appeared eyelid retraction and exophthalmos, Make every patient seem to be glaring. If it continues to develop, Crowded space affects the optic nerve, More serious manifestations such as blurred vision and vision loss occur. In patients with thyroid-related ophthalmopathy, About 90% were complicated with hyperthyroidism, In addition, other thyroid diseases such as hypothyroidism and thyroiditis can be seen. Ophthalmic diseases can occur simultaneously with thyroid diseases. It can also happen before or after it appears. Like [Brother Glasses], many patients suffer from these symptoms. At present, worldwide, Grave’s eye disease has more than 10 million patients, More than one million new patients are added each year, The incidence rate of women is 4 ~ 5 times that of men, especially middle-aged women over 40 years old, which is the high incidence population of the disease. Smoking is an important risk factor affecting the disease. In some regions with high smoking rate, such as Eastern Europe and South Asia, the incidence rate is higher, even as high as 20 times that of other regions. How should thyroid-related ophthalmopathy be treated? For all patients, The most important thing is to use drugs to improve thyroid function. At the same time strictly quit smoking. For some eye symptoms are not obvious, Patients who have less influence on daily life, Eye drops and eye ointment can be used to protect cornea, Relieve foreign body sensation, Wear sunglasses to relieve photophobia, Raise the head of the bed during sleep to reduce edema. If eye symptoms are severe, Affect daily life, Especially during the active period of the disease, When eyelid swelling, conjunctival congestion and other symptoms are obvious, Hormonal drugs and radiotherapy can effectively improve symptoms, Control the development of the disease. But if the treatment is not effective, There is even a sharp decline in vision, keratopathy, Surgical treatment is needed as soon as possible to save vision. For patients who need to improve their appearance, You can also receive surgical treatment six months after the eye condition is stable and thyroid function is normal. One week after the first meeting in the clinic, Brother Glasses underwent orbital decompression surgery in our hospital. The operation was very successful. His eyesight recovered from 0.1 to 0.6, and his eyes turned back. The moment he uncovered the gauze, he looked at himself in the mirror with joy and sighed, “You are really magicians!” It changed me back in one fell swoop! This is the first time he has smiled in three years. I have seen a TV play called “Back to Yesterday” before. It is about a girl who went through all kinds of difficulties through time and space with the help of a doctor, returning to her youth and making up for many regrets. One day I found that what we are doing now is to help patients return to yesterday, return to their original appearance, and regain their old confidence and happy life. There is no way to get back from a doctor.