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Ophthalmology A Short Textbook - part 8

Trích xuất trong thời thơ ấu có thể dẫn đến quỹ đạo hypoplasia toàn cầu cung cấp một sự kích thích tăng trưởng cho khoang quỹ đạo. Do đó các bệnh nhân kịp thời sẽ nhận được một chi giả. | 15.4 Autoimmune Disorders and the Orbit Craves Disease 411 15.3.4 Osteopathies Many of these disorders can produce orbital changes. The most common of these diseases include Paget s disease of bone dysostosis multiplex Hurler s syndrome and marble-bone disease of Albers-Schonberg in which compressive optic neuropathy also occurs. 15.4 Orbital Involvement in Autoimmune Disorders Craves Disease Definition Autoimmune disorder with orbital involvement frequently associated with thyroid dysfunction. Histologic examination reveals inflammatory infiltration of the orbital cavity. Epidemiology Women are affected eight times as often as men. Sixty per cent of all patients have hyperthyroidism. Ten per cent of patients with thyroid disorders develop Graves disease during the course of their life. H Craves disease is the most frequent cause of both unilateral and bilateral exophthalmos. Etiology The precise etiology of this autoimmune disorder is not clear. Histologic examination reveals lymphocytic infiltration of the orbital cavity. The ocular muscles are particularly severely affected. Fibrosis develops after the acute phase. H An autonomous adenoma of the thyroid gland is not associated with Craves disease. Some patients with Craves disease never exhibit any thyroid dysfunction during their entire life. Symptoms The onset of this generally painless disorder is usually between the ages of 20 and 45. Patients complain of reddened dry eyes with a sensation of pressure symptoms of keratoconjunctivitis sicca and of cosmetic problems. Ocular motility is also limited and patients may experience double vision. Diagnostic considerations Cardinal symptoms include exophthalmos which is unilateral in only 10 of all cases and eyelid changes that involve development of a characteristic eyelid sign Table 15.3 and Fig. 15.3 . Thickening of the muscles primarily the rectus inferior and medialis and subsequent fibrosis lead to limited motility and double vision. Elevation is impaired this