Endocrine Abstracts

Background: Thyroid eye disease (TED) is a common manifestation of Graves’ disease, ranging from mild symptoms to sight-threatening complications. Early recognition is essential for timely ophthalmology referral. An initial audit at our centre identified gaps in documenting TED symptoms and risk factors.

Aim: To evaluate whether a standardised TED proforma improved documentation quality in patients with Graves’ disease.

Methods: Two retrospective audits were conducted at the endocrine thyroid clinic, St. Vincent’s University Hospital: an initial audit (November 2024, n = 26) and a re-audit (June 2025, n = 20) after introducing a standardised proforma. Data collected included TED assessment, patient-reported symptoms, symptom-specific findings, and smoking status. Proportions were compared using Fisher’s exact test (P < 0.05).

Results: TED assessment was documented in 92% of patients (24/26) initially vs 100% (20/20) post-proforma (P = 0.49). Smoking status documentation improved significantly (54% vs 100%, P < 0.001). The proportion of patients with documented specific symptoms increased for eyelid swelling (27% to 50%, P = 0.04), diplopia (15% to 40%, P = 0.03), and visual acuity changes (4% to 20%, P = 0.04), all statistically significant. Documentation of proptosis (31% to 45%, P = 0.27) and eye pain (19% to 15%, P = 0.75) also improved, though not significantly. The proportion of patients diagnosed with TED remained similar (50% vs 35%, P = 0.31).

Conclusion: A standardised proforma significantly improved documentation of TED symptoms and smoking status. Incorporating structured tools into endocrine clinics can enhance TED recognition and facilitate timely ophthalmology referral.