DIFFERENTIAL-DIAGNOSTIC ASSESSMENT OF CLINICAL FORMS OF ENDOCRINE OPHTHALMOPATHY
Aim - to study the basic criteria of differential-diagnostic evaluation of clinical forms of endocrine ophthalmopathy. Materials and methods From November 2009 to 2017, 36 patients were referred. All patients underwent a complete ophthalmological examination: visometry biomicroscopy, esophthalometry, ultrasound of the eyeball and orbit, tonometry, ophthalmoscopy, computed tomography of the orbit. Of the examined patients, 11 patients had thyrotoxic exophthalmos, in 19 patients had edematous exophthalmos, in 5 patients had endocrine myopathy. Results In patients with thyrotoxic exophthalmos, there was an increase in the ocular gap, shine in the eyes, tremor of closed eyelids, slowing of the movement of the upper eyelid when viewed downward. Serious changes from the eyeball was not found. Patients with edematous exophthalmos were divided into 3 groups: the stage of compensation, the stage of subcompensation, the stage of decompensation. In these patients, the process can be one-sided or two-way. In the initial stages, a ptosis of the upper eyelid was observed on one eye, and retraction on the other. Endocrine myopathy developed already during the transition of the process to the chronic phase. In these patients, fibrotic muscles limited the movement of the eyeball, were the cause of strabismus and diplomacy. At this stage, the treatment of patients is very difficult and, in general, is symptomatic. Conclusion In assessing the clinical forms of endocrine ophthalmopathy, in addition to the basic criteria as the degree of exophthalmos, other symptoms are of great importance: the state of the cornea and optic nerve, intraocular pressure, reposition and volume of movements of the eyeball, strabismus and diplopia, conjunctival chemosis.