Demography, clinical presentation and management of thyroid orbitopathy: A prospective interventional cohort study at a regional institute of ophthalmology in Western India

Introduction: Thyroid orbitopathy or Graves’ orbitopathy has been known since almost two centuries with the ocular changes associated with thyroid disease being first published by Graves in 1835. Thyroid orbitopathy is an autoimmune disorder. It is a life -long disease with systemic and ocular manifestations. Early diagnosis and appropriate management of this disorder are essential. The European group on graves orbitopathy has put forward new updated guidelines for the management of this disorder. We designed a study to document the demographics, clinical presentation and management of Thyroid orbitopathy patients at our institute as per the new guidelines. Aim: The current study aims to showcase the demography, clinical presentation and management of thyroid orbitopathy at a centre of excellence in western India. Materials and Methods: The study design was a prospective interventional study in an institutional cohort. The study was carried out over a period two years from August 2017 to October 2019. Thirty five consecutive cases of Thyroid orbitopathy presenting to the oculoplastics and ocular oncology clinic of our western regional institute of ophthalmology were studied. They were subjected to a thorough history taking, clinical examination. The thyroid ophthalmopathy was classified as mild, moderate to severe, sight threatening. Active or inactive orbitopathy was documented. The patients were managed as per the recent upadated globally accepted guidelines for the management of thyroid orbitopathy. Observation and Results: Thyroid associated opthalmopathy was found in all age groups. The age range was twelve years to seventy years. The maximum incidence was seen in the age group of thirty five to fifty five years (68.57%). It was more common in females (female: male ratio was 4:3). The most common clinical presentation was eyelid retraction(91.43%)followed by exophthalmos (77.14%). The patients had the whole spectra of the ophthalmopathy from mild (65.72%) ,mo