Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Book

Dysthyroid Optic Neuropathy

Ayushi Agarwal  1 , Samreen Khanam  2
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
Affiliations
Free Books & Documents
Book

Dysthyroid Optic Neuropathy

Ayushi Agarwal et al.
Free Books & Documents

Excerpt

Dysthyroid optic neuropathy (DON) represents the most dreaded manifestation of thyroid eye disease (TED), one of the most common autoimmune diseases of the orbit. DON, previously termed the crowded orbital apex syndrome, is characterized by thyroid-related impairment of optic nerve function that may lead to profound vision loss. The European Group on Graves Orbitopathy (EUGOGO) classifies the severity of TED as mild, moderate-severe, or sight-threatening. Sight-threatening TED, characterized by DON or keratopathy, warrants urgent intervention (see Image. Left Corneal Exposure Keratopathy With Bilateral Optic Nerve Involvement). DON is a multifactorial entity whose diagnosis is extremely challenging owing to its early subclinical stage, the presence of confounding factors, and alternative causes of sight loss in TED. A thorough evaluation of DON and subsequent timely management are crucial to avoid permanent blindness in TED.

PubMed Disclaimer

Conflict of interest statement

Disclosure: Ayushi Agarwal declares no relevant financial relationships with ineligible companies.

Disclosure: Samreen Khanam declares no relevant financial relationships with ineligible companies.

References

    1. Dolman PJ. Dysthyroid optic neuropathy: evaluation and management. J Endocrinol Invest. 2021 Mar;44(3):421-429. - PubMed
    1. Bartalena L, Baldeschi L, Dickinson A, Eckstein A, Kendall-Taylor P, Marcocci C, Mourits M, Perros P, Boboridis K, Boschi A, Currò N, Daumerie C, Kahaly GJ, Krassas GE, Lane CM, Lazarus JH, Marinò M, Nardi M, Neoh C, Orgiazzi J, Pearce S, Pinchera A, Pitz S, Salvi M, Sivelli P, Stahl M, von Arx G, Wiersinga WM, European Group on Graves' Orbitopathy (EUGOGO) Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO. Eur J Endocrinol. 2008 Mar;158(3):273-85. - PubMed
    1. Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA. Clinical features of Graves' ophthalmopathy in an incidence cohort. Am J Ophthalmol. 1996 Mar;121(3):284-90. - PubMed
    1. Bahn RS. Graves' ophthalmopathy. N Engl J Med. 2010 Feb 25;362(8):726-38. - PMC - PubMed
    1. Wiersinga WM. Management of Graves' ophthalmopathy. Nat Clin Pract Endocrinol Metab. 2007 May;3(5):396-404. - PubMed

Publication types

LinkOut - more resources