Thyroid Orbitopathy and Dry Eye

Thyroid orbitopathy (TO) is an inflammatory autoimmune disease of the orbital and periorbital tissues that is characterized by the presence of autoantibodies against thyroid-stimulating hormone receptor (TSH-R). Hyperthyroidism and less commonly hypothyroidism or euthyroidism can be associated with this disorder. The orbital fibroblasts activated with T cells and the secreted cytokines are the key cells in the etiology. Dry eye can be seen in 80% of TO patients. The main factor for the development of dry eye in these patients is the inflammation of the lacrimal gland and the ocular surface. The second factor is the hyperosmolarity of the tear film caused by the evaporation of the tear film due to exophthalmos and the increased interpalpebral distance. In the treatment of TO, the usage of topical anti-inflammatory agents along with artificial tears is important because of the role of inflammation in the etiology. (Turk J Oph thal mol 2011; 41: 348-50