Retrobulbar irradiation for thyroid eye disease (IPG148)
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on retrobulbar irradiation for thyroid eye disease
Thyroid eye disease (also known as dysthyroid eye disease, Graves' eye disease, Graves' ophthalmopathy, or thyroid orbitopathy) is a disease that predominantly affects the extraocular muscles. It affects an estimated 400 000 people in the UK assuming a 37.5 % prevalence of thyroid eye disease in Graves' disease (1). It is the most common cause of unilateral or bilateral proptosis (prominent or staring eyes) in adults, due to enlarged eye muscles and an increase in the fatty tissue behind the eyes.
Patients are commonly treated on an outpatient basis. The patient is placed in a supine position, and the head fixed with a full head shell. Irradiation is given with photons generated by a linear accelerator targeted at the retobulbar content of the orbit, and the full dose delivered in about 10 fractions over a two week period.
X65.4 Delivery of a fraction of external beam radiotherapy NEC
Y91.- External beam radiotherapy
Z16.9 External structure of eye NEC
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
- IPG148 Retrobulbar irradiation for thyroid eye disease: guidance (web format)
- IPG148 Retrobulbar irradiation for thyroid eye disease - guidance
- IPG148 Retrobulbar irradiation for thyroid eye disease - information for the public
- Interventional Procedures Consultation Document - Retrobulbar irradiation for thyroid eye disease
- Interventional Procedures Overview - Retrobulbar irradiation for thyroid eye disease
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Information for the public
Implementation tools and resources
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The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.