1.Pavlov First Saint Petersburg State Medical University L'va Tolstogo str. 6-8 Saint Petersburg, Russia 197022
2. St. Petersburg state budgetary institution of health care "City multidiscipline hospital no.2" Uchebnyy Pereulok, 5, St Petersburg, Russia 194354
3. North-Western State Medical University named after I.I. Mechnikov Kirochnaya str. 41 Saint-Petersburg, Russia, 191015
4. Saint-Petersburg State Pediatric Medical University
Brief summary
Upper eyelid retraction is the most common thyroid eye disease manifestation. It leads to visual impairment and entails a number of complications such as exposure keratopathy, lagophthalmos and cosmetic alterations that affects the patient's quality of life. The detailed algorithm of thyroid eye disease associated upper eyelid retraction is presented under this article. When examining patients with thyroid eye disease-associated upper eyelid retraction, it is necessary to intervew, including using the OSDI questionnaire, and a history taking. It?s essential to measure not only the degree of retraction of the upper eyelid, but also the width of the palpebral fissure in the center and along the medial and lateral limbs to the position of the upper eyelid evaluation. In addition, the upper eyelid retraction on the contralateral side should be excluded. Along with this, due to the instability of the position of the upper eyelid, gaze fixation tests and phenylephrine test are recommended. It is also important to assess the degree of lagophthalmos, the frequency of complete closure of the eyelids, and the Bell's phenomenon to evaluate exposure keratopathy. The correct algorithm will help to choose adequate treatment up to time.
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