Endocrine Abstracts

Patients with thyroid eye disease (TED) often appear distressed. It is probable that several factors contribute to their psychological state, but the predominant components seem to be alterations in visual function and abnormal facial appearance. It is well recognised that people with disfigurement encounter significant difficulties in social interaction. The altered appearance of a patient with TED may lead to a usually negative experience, followed by misinterpretation of the TED patient's emotions and attitudes by third parties. The specific changes in the eyes associated with TED have a particularly profound effect on social interaction. Engaging in eye contact and blinking play an essential role in sustaining the flow of social interaction, yet patients with TED stare and blink infrequently. The ability to cope can differ from individual to individual, depending on their resources. However, if the TED sufferer has an inherent belief that others are poised to stigmatise and reject them, they may well go to a great deal of trouble to conceal their eyes for example, by wearing dark glasses or make up. This coping mechanism in itself may well compound the situation for the TED patient as there is some evidence to suggest that the distress an individual feel may well in part be associated with the stress of attempting to conceal a particular feature. The influence of altered appearance, thyroid dysfunction, abnormal social interaction, coping mechanisms and quality of life on psychological morbidity will be discussed within this presentation.