BIOCHEMICAL MARKERS OF THYROID DYSFUNCTION AND ASSOCIATED OCULAR CHANGES IN CHILDREN
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Keywords
Thyroid dysfunction, pediatric ophthalmology, proptosis, eyelid changes, TSH, autoimmune thyroid disease, ocular involvement
Abstract
Background: Thyroid problems in children often develop quietly, and the earliest signs may appear in the eyes long before parents or clinicians suspect an endocrine disorder. Many young patients do not complain of visual discomfort, making it easy for thyroid-related eye changes to go unnoticed. Recognizing how hormonal disturbances relate to specific ocular patterns may help clinicians detect thyroid disease earlier.
Methodology: A cross-sectional study was carried out between January 2024 and January 2025 at HBS Medical and Dental College, Islamabad. Sixty-two children aged 5–15 years who were being evaluated for possible thyroid dysfunction were enrolled. Each child underwent a structured clinical assessment, thyroid profile testing, and a detailed ophthalmic examination that included eyelid assessment, tear film evaluation, measurements of proptosis, extraocular movements, and visual acuity. All laboratory and clinical data were analyzed using SPSS (version 20).
Results: Eye changes were noticeably more common among children with abnormal thyroid hormone levels. Eyelid retraction, forward displacement of the eyeball, and mild motility restriction showed the clearest association with biochemical dysfunction. Children who had proptosis also tended to show higher TSH values and reduced FT4 levels. Tear film instability and conjunctival redness were seen frequently but were not statistically decisive in every comparison. Autoantibody positivity appeared more prominent among those with orbital involvement.
Conclusion: The study shows that children with thyroid abnormalities display a range of ocular signs, some of which emerge early in the course of the disease. Features such as proptosis and eyelid changes appear to have the strongest link with disturbed thyroid hormone levels. Routine examination of the eyes in children being assessed for thyroid disorders may improve early detection and help prevent long-term visual problems.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Irfan
Senior Registrar, Department of Ophthalmology, HBS Medical and Dental College, Islamabad, Pakistan
Junaid Afsar Khan
Assistant Professor, Department of Ophthalmology, CMH Lahore Medical College & Institute of Dentistry, Lahore, Pakistan
Roomana Anwar
Associate Professor, Department of Biochemistry, HBS Medical and Dental College, Islamabad, Pakistan
Shagufta Razzaq
Demonstrator, Department of Biochemistry, Foundation University of Health Sciences, Islamabad, Pakistan
Anam Arshad
Assistant Professor, Department of Biochemistry, Central Park Medical College, Lahore, Pakistan
Adeel Haidar
Associate Professor, Oral Pathology and Oral Diagnostics, University College of Dentistry,
University of Lahore, Pakistan
