TJ-CEO
2015 , Vol 10 , Num 1
Diagnosis of Post-Total Thyroidectomy Hypocalcaemia By An Ophthalmologist
1M.D. Asistant Professor, Bulent Ecevit University Faculty of Medicine, Department of Ophthalmology, Zonguldak/TURKEY2M.D. Professor, Bulent Ecevit University Faculty of Medicine, Department of Ophthalmology, Zonguldak/TURKEY To present a case of profound hypocalcaemia associated with the development of bilateral cataracts after total thyroidectomy. A 33-year-old woman applied to our clinic because of vision loss for 8 months. She had also mild paresthesia in distal extremities. Preoperative calcium level was 8.0 mg/dl (Reference Range: 8.6-10), thyroid stimulating hormone was 0.628 IU/ ml (Reference Range: 0,4-4), free T4 was 1.12 ng/dl (Reference Range: 0.89-1.76), free T3 was 4.13 pg/ml (Reference Range: 1.8-4.7) and parathyroid hormone was 8pg/ml (Reference Range: 16-87 pg/ml). The patient was clinically euthyroid but parathyroid hormone level was low. Uncorrected visual acuity in both eyes were 0.016. Biomicroscopic examination revealed symmetric complete cortical cataract in both eyes. Patient had not taken sufficient treatment for hypocalcemia till she came to our hospital. After treatment, her paresthesia symptoms improved. It is very important not to overlook hypocalcaemia diagnosis which is a rare cause of cataract even without any obvious systemic symptoms. Ophthalmologists can be the first doctors that diagnose hypocalcaemia as in our case. Especially young patients presenting with cataract should be questioned about thyroid surgery and also checked for calcium levels. Keywords : Hypocalcemia, hypoparathyroidism, cataract, total thyroidectomy