Eye symptoms DIF FUZNOGO toxic goiter

Eye symptoms DIF FUZNOGO toxic goiter result from complex neurohormonal disorders IU mechanism of which to the end ne.raskryt . They usually occur with diffuse toxic goiter.

Ocular symptoms diffuse toksichekogo goiter (GSDT3) mainly consist of exophthalmos and disorders associated with eating friendly eye movements GOVERNMENTAL apples (Mobius symptom) and facial muscles due miaste Nia glazodvigatel facial muscles and muscle activation, oculomotor nerve lesion nuclei.

  •                From mnogochis PARTICULAR GS DT3 leading place is occupied Exophthalmos (E).

Susche exists a number of hypotheses to explain the reasons for its development, but none of them are not able to reveal the entire mechanism of this process. Ex experimentally found that ext pAKT anterior pituitary TSH in particular, administering to the animal mu besides cause hyperthyroidism exophthalmos. However, clinical observations show that with diffuse toxic goiter, when TSH hypersecretion occurs in almost all cases, exophthalmos is observed in a few. From known that hypothyroidism secre tion of TSH is greatly improved, but it does not develop exophthalmos. Studies in recent years show whether that factor causing exophthalmos is not itself TSH and finding Esja him substance called ” exophthalmic factor.” Pref assumed that the

In practice, unilateral exophthalmos is often observed . This fact indicates that exophthalmia not completely pre determined exophthalmic factor torus. In all likelihood, this is the role of vegetativ naya nervous system, particularly the sympathetic, which was confirmed experimentally: the stimulation of the cervical sympathetic nerves in Ms votnyh there exophthalmos. A direct hydrochloric cause exophthalmos is increased tone glazodvigatel extensor muscle activation, increased retrobulbar tissue, in particular, acidic mucopolysaccharides (boost boiling hydrophilicity of tissue), fat and connective tissue. This leads to a sharp increase intraorbi tal pressure to the stagnation in the eyelids and puffiness.

There are a number of other theories.
For example, according to the autoimmune theory thyroglobulin can be an antigen and, coming into contact with tireoidinom together with a B-lymphocyte in E , is fixed on the cell mem branes ekstrakulyarnyh muscle you zyvaya their damage followed conductive retrobulbar tissue edema development. Exophthalmos explain and violation of a lymph drainage in the thyroid gland, which should lymphostasis and swelling extra ocular and retrabulbarnyh tissues. Along with swelling retrabulbarnoy and intrabulbarnoy tissue crumbling tone oculomotor nerves and muscles, which leads to at Rushen friendly movements of eyeballs. Often observed in individuals not suffering from thyrotoxicosis.

There is evidence that the so- Vai euthyroid exophthalmos content of thyroid hormones in the blood, in particular T 3 , is raised, but without tachycardia, and weight loss. Assume Gaeta, that this is due to exophthalmos hyperthyroidism, but the sensitivity Nosta peripheral receptors to them is reduced, and the recipe ditch eye muscles, on the contrary, -povy shennoy. Euthyroid proptosis is often lo mein in nature, and often in the department GOVERNMENTAL family members may develop hyperthyroidism. At the same time hyperthyroidism in these individuals do not necessarily tion is accompanied by weight loss, sometimes there is some fat, which, in all probability, due to the simultaneous SHOCK Niemi diencephalic formations.

Histologically first notes Xia edema and cellular infiltration of the retro-orbital tissue lymphocyte E, macrophages and plasma cells.
Further in myshech GOVERNMENTAL fibers – edema, loss Priest River striation , homogenization with increasing sizes up to 10 times to increase their kontraktilyyusti .

The speed and degree of development of exophthalmos varies widely from several weeks to a year. Rarely, the development of exophthalmos is fulminant.
Subjective symptoms of exophthalmos YaV lyayutsya tearing , pain behind the eye E, the motion of the eyeball E unpleasant feeling a sense of “sand in the eyes”, especially when in the view of stresses, Initially, it swells the upper eyelid, in marked degree and bottom, and on the region of the temple, frontal bone. Mucosal hyperemia causes edematous progress STI and leads to himozu , forms a camping shaft around edematous cornea to evert the lower eyelid. The mucous membrane undergoes drying and ulceration. Exophthalmos rate with dashes toxicosis ranges from 10 to 40%. The degree of protrusion of the eyeballs is determined by an exophthalmometer.

By expressibility, exophthalmos is divided into four degrees:

  •                Grade 1 (mild form) – moderate exophthalmos with a slight violation of the function of the eyes motor muscles. Eye protrusion 15.9 + 0.2 mm.
  •                Grade 2 (moderate severity) – moderate proptosis with mild dysfunction of the eye muscles, and non-severe changes of the kon yunktivy. Eye protrusion 17.9 + 0.2 mm.
  •                3rd degree (severe form) —sharp pronounced exophthalmos with impaired closure of the eyelids. Pronounced change in the conjunctiva and function of the eye muscles, not heavy defeat horns tzu, the initial effects of atrophy behold tion nerve. Eye protrusion 22.8 ± 1.1 mm.
  •                4-th degree (extremely severe) -you expressions manifestation vysheizlozhen cardinal symptoms with the threat of loss of view Nia and eyes. Protrusion over 24 mm.

In addition exophthalmos describes a number of eye symptoms characteristic dash toxicity:

  •                Abadi symptom (1842-1932, France) – spasms of muscles that raise the eyelid.
  •                Ballet symptom (1888) – Cha -particle or total immobility of one or more external muscles of the eye without defeat internal these muscles.
  •                Burke’s symptom is expansion and pulsation of the retinal vessels.
  •                Bell symptom – SFA deviation for upwardly and outwardly closing the active optic fissure.
  •                Boston symptom (1871 – 1931 years,. Amer doctor.) -Otryvistoe, uneven dimensional delay of the upper eyelid at the drive looking down.
  •                Botkina symptom (1850) – E moletnoe expansion slots eye gaze during fixation.
  •                Brahma symptom. During laughter the eyes are wide open, at the same healthy eye slits considerable tion narrowed.
  •                Gauvin symptom – sous jerky voltage pupil of one eye when illum schenii another.
  •                Goldziger symptom – conjunctival hyperemia.
  •                Gref symptom (1823-1870 gg., German ophthalmologist). Patients are asked to watch for the eye Pal CEM, which leads examiner ne ed eyes (at a distance of 30 – 40 cm) from top to bottom while Dru goy hand doctor supports of catching the patient, so that he could not DWI causeway it. When positive symptom IU upper eyelid and retarded yc PEVA the movement of the eye BU Lok down. As a result, a conjunctival band opens between the upper eyelid and the cornea limb . This symptom is the result of increased muscle tone, raised cerned upper eyelid.
  •                Griffta symptom – delay of the lower eyelid when closer vzglya de on an object at the level no eyes.
  •                Dalrymplya symptom (1804 – 1852, Scotlan . Ophthalmologist). When fixing view on the subject, locat dyaschemsya at pupil, eye slit open wide. In this disclosed portions of the sclera, normally covered by the upper and lower E centuries. Paresis caused by torsion govyh muscles century.
  •                Gifford symptom (1906, Britain). Due to the thickening and Vyshen tone muscles of the upper eyelid is turned out with great difficulty.
  •                Jellineka symptom (1187, Austrian physician) – eyelid skin pigmentation. Ras regarded as a sign of insufficient accuracy of the adrenal glands.
  •                Geoffrey symptom (1844-1908, French physician). Looking up at the forehead does not form wrinkles: āste Nia frontal muscles.
  •                Zatlere symptom – poor Pinch rivanj.
  •                Zenger-Entrouta symptom – by dushkoobraznaya eyelid swelling.
  •                Ibn-sina symptom – retroocular resistance with exophthalmos.
  •                Kniss symptom – anisocoria.
  •                Kouena symptom – vibration zrach Cove.
  •                Kocher symptom (1841-1917, Swiss surgeon). Patients should be investigated for the finger, led by the ne ed his gaze upwards. When for positively symptom sclera, nor in IU located under the upper eyelid, is exposed, it becomes prominent. The symptom is caused by a rapid displacement of the upper eyelid, eye than Nogo apples, due to the increase of its tone.
  •                Levy symptom. Expanding zrach ka under the influence of the conjunctiva weak adrenaline solution.
  •                Moebius symptom (1880). With the rapid movement of a finger from la teralnoy side to the middle of the eye Noah apple does not keep pace with the swipe of a finger and comes transient strabismus. Violation of convergence is due to the weakness of direct vnut eyes nal
  •                Mina symptom is a delay in the eyeballs behind the movement of the eyelids with a closer look.
  •                Niza symptom – uneven expansion of the pupils.
  •                Popov symptom (USSR)-jump shaped movement of the upper eyelid during the top-down view.
  •                Repro -Melihova simplex is (USSR) characterizable angry vzglya home patients.
  •                Rosenbach’s symptom (1851-1907, German, doctor) – trembling of the eyelids when they are closed.
  •                Snellen symptom (1834-1908 gg .. Netherlands ophthalmologist.) – buzzing of, listens stethoscope over closed eyes. It is characteristic of thyrotoxic exophthalmos.
  •                Spector symptom – painful Nosta oblique muscle attachment points to the sclera at the initial eq zoftalme.
  •                Stasinskogo symptom – inetsi tion of the cornea with a red cross.
  •                Topolyansky symptom (USSR) – conjunctival hyperemia in the form of a “red cross”.
  •                Wilder’s symptom. If the eyeball is at the edge of his abduction and starts to move the camping to the center, its offset proish dit steps, with stops.
  •                Shtelvaga symptom (1869 av -str. Ophthalmologist) -retraction top it century in combination with a rare mi ganiem due chuvst lowering the cornea pheno-.
  •                Ecrota symptom – swelling of the upper eyelid.
  •                Jaffe symptom – the inability to wrinkling his forehead, as if sympto IU Geoffroy , caused by lowering it tone the frontal muscles.

Not all eye symptoms of thyrotoxic goiter detected in isolating them, and the same patients thyrotoxic patients Zom, more common symptoms Gre Fe, Kocher , dalrymple , related to violation of the upper eyelid function, symptoms Jaffe and Geoffrey, a symptom we Rosenbach , Shtelvaga , connected nye with neurogenic factors , and finally , Mobius, Wilder, Obus lovlennye violation of eye convergence.

local_offerevent_note April 10, 2020

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