Abstract
Purpose :
To describe visual outcomes and characteristics of thyroid eye disease patients undergoing therapeutic contact lens use at a tertiary care center.
Methods :
Records were identified and reviewed of consecutive patients with a diagnosis of thyroid eye disease utilizing billing records with ICD 9 code 242.0, 376.21 or ICD 10 code E05.00. Eligible patients were those evaluated in the contact lens service of the Illinois Eye and Ear Infirmary at the University of Illinois at Chicago between July 1st 2015 and July 1st 2020. Demographics, history of orbital decompression, eyelid/orbital surgery, orbital radiation, clinical findings, visual acuity and contact lens parameters were recorded. Snellen visual acuities were converted to LogMAR for analysis. Descriptive statistics are presented as well as paired T tests.
Results :
Fourteen patients met inclusion criteria with a mean age of 59.6 years [15.3, 30-80]. The majority were female (78.6%). About one third of the patients had undergone orbital decompression surgery (n=5/14) and 3 had non-healing corneal epithelial defects. Clinical findings in these patients included punctate keratitis 78.6%, eyelid retraction 50.0%, bulbar conjunctival injection 42.9%, corneal scarring 35.7% and corneal thinning and steepening consistent with keratoconus 14.3%. There were 7 patients fit with soft lenses, 1 with corneal gas permeable lenses, 1 with hybrid and 5 with scleral lenses.
Vision in the right eye improved from baseline mean LogMAR 0.41 [0.47, 0.0-1.46; n=13] to 0.07 [0.11, 0.0- 0.30) with contact lenses (difference in means 0.34, 95%CI[0.076 to 0.598], t(12)=2.81, P=0.016).
One left eye was limited to light perception; however the other eyes improved from mean baseline LogMAR 0.55 [0.58, 0.0-1.83; n=13] to 0.065 [0.12, 0.0- 0.40) with contact lenses (difference in means 0.49, 95%CI[0.188 to 0.789], t(12)=3.55, P=0.004).
Conclusions :
This series of patients demonstrates the characteristics of patients with thyroid eye disease. Moreover, therapeutic lenses, including soft and scleral lenses, were utilized most often and associated with visual improvement.
This is a 2021 ARVO Annual Meeting abstract.