The thyroid-stimulating hormone of a patient with hyperthyroidism and exophthalmos is slowly normalizing on propylthiouracil, but her eyes remain abnormal in appearance. She has seen an ophthalmologist and assures me that the only finding was some watering in one eye. Does exophthalmos ever go away? Are there other precautions I should be taking for her eye health?
—Melinda Ninefeldt, PA-C, Kettle River, Minn.
Treatment of the thyroid disorder is the basis for management of exophthalmos. Resolution may take one to two years once the disorder is controlled. Lubricating drops may be necessary. Close follow-up of both the thyroid status and exophthalmos is mandatory. If the patient has no visual problems, watchful waiting is recommended. Surgery may be a consideration in the event of complications, such as visual disturbances or head pain.
—Claire B. O’Connell, MPH, PA-C (102-17)