Aim: To report recurrent thyroid eye disease, which is unusual because the condition is considered a monophasic disease and recurrence is rarely reported.
Method: A retrospective case note review was carried out on all patients who had attended the thyroid eye disease clinic in our hospital. Six patients with recurrence of their disease were identified. One case is presented in detail and the clinical findings of 5 similar cases are documented.
Results: Of the 6 patients, 5 were female. The average age at time of diagnosis with thyroid eye disease was 47 years and at the time of recurrence was 56 years. All were managed conservatively at their first presentation but 4 patients required radiotherapy to control the recurrence. Three patients required squint surgery after their disease reactivated. The most common operation for strabismus was an inferior rectus recession.
Conclusions: Thyroid eye disease is considered to be a monophasic autoimmune disease with an initial active phase of progressive deterioration followed by a static phase with gradual improvement over the years. The cases presented show that the natural history of the disease does not always follow this conventional pattern and this is an important consideration when planning future management.