Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

What the Internist Should Know About the Ophthalmopathy of Graves' Disease

What the Internist Should Know About the Ophthalmopathy of Graves' Disease Abstract Although noninfiltrative ophthalmopathy can be seen with hyperthyroxinemia on any basis, infiltrative ophthalmopathy is peculiar to Graves' disease. With infiltrative ophthalmopathy involvement of extraocular motor muscles can cause shortening of the levator palpebrae superiorus and fixed upper eyelid retraction. Paresis of other muscles may cause diplopia or strabismus. Complications of proptosis include corneal damage from exposure and optic nerve injury from traction or compression; from venous engorgement: chemosis, subconjunctival hemorrhage, orbital pain, and glaucoma. Restoration of the euthyroid state improves noninfiltrative ophthalmopathy. For mild infiltrative disease, local and mechanical measures may provide symptomatic relief. Adrenal steroids are indicated for progressive infiltrative ophthalmopathy. The principal indications for surgical intervention are cosmetic, for correction of diplopia, or for decreased vision. For best results, surgery must be properly timed and planned. References 1. Pollard JB: Exophthalmos: Diagnostic challenge—therapeutic enigma. Southern Med J 60:815-818, 1967.Crossref 2. Zacharewicz FA: The ophthalmopathy of hyperthyroidism. GP 36:88-97, 1967. 3. Garber MI: Methylprednisone in the treatment of exophthalmos. Lancet 1:958-960, 1966.Crossref 4. Gay AJ, Wolkstein MA: Topical guanethidine therapy for endocrine lid retraction. Arch Ophthal 76:364-367,1966.Crossref 5. Brown J, Coburn JW, Wigod RA, et al: Adrenal steroid therapy of severe infiltrative ophthalmopathy of Graves' disease. Amer J Med 34:786-795, 1963.Crossref 6. Day RM, Carroll FD: Optic nerve involvement associated with thyroid dysfunction. Trans Amer Ophthal Soc 59:220-238, 1961. 7. Burrow GN, Mitchell MS, Howard RO, et al: Immunosuppressive therapy for the eye changes of Graves' disease. J Clin Endocr 31:307-311, 1970.Crossref 8. Catz B, Perzik SL: Subtotal versus total ablation of thyroid: Malignant exophthalmos and its relation to remnant thyroid , in Cassano C, Andreoli M: Current Topics in Thyroid Research. New York, Academic Press Inc, 1965, p 1183. 9. Pequenat EP, Mayberry WE, McConahey WM, et al: Large doses of radioiodine in Graves' disease: Affect on opthalmopathy and long-acting thyroid stimulator. Mayo Clin Proc 42:802-811, 1967. 10. Werner SC, Feind CR, Aida M: Graves' disease and total thyroidectomy. New Eng J Med 276:132-137, 1967.Crossref 11. Goldstein I: Recession of levator muscle for lagophthalmos in exophthalmic goiter. Arch Ophthal 11:389-393, 1934.Crossref 12. Henderson JW: Relief of eyelid retraction. Arch Ophthal 74:205-216, 1965.Crossref 13. Miller JE, Van Heuven W, Ward R: Surgical correction of hypotropia associated with thyroid dysfunction. Arch Ophthal 74:509-515, 1965.Crossref 14. Long JC: Surgical management of the tropias of thyroid exophthalmos. Arch Ophthal 75:634-638, 1966.Crossref 15. Haddad HM: Needle aspiration of malignant (progressive) endocrine exophthalmos. Arch Ophthal 80:703-704, 1968.Crossref 16. Callahan A: Reconstructive Surgery of the Eyelids and Ocular Adnexa. Birmingham, Ala, Aesculapius Publishing Co, 1966, p 237. 17. Naffziger HC: Progressive exophthalmos. Ann Roy Coll Surg Eng 15:1-24, 1954. 18. MacCarty CS, Kenefick TP, McConahey WM, et al: Ophthalmopathy of Graves' disease treated by removal of roof, lateral walls, and lateral sphenoid ridge: Review of 46 cases. Mayo Clin Proc 45:488-493, 1970. 19. Berke RN: A modified Krönlein operation. Arch Ophthal 51:609-632, 1954.Crossref 20. Sinskey RM: The management of metabolic malignant exophthalmos. Arch Ophthal 66:214-218, 1961.Crossref 21. Kroll AJ, Casten VG: Dysthyroid exophthalmos palliation by lateral orbital decompression. Arch Ophthal 76:205-210, 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

What the Internist Should Know About the Ophthalmopathy of Graves' Disease

Loading next page...
 
/lp/american-medical-association/what-the-internist-should-know-about-the-ophthalmopathy-of-graves-TUnWm0TB70

References (23)

Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1972.00320010135021
Publisher site
See Article on Publisher Site

Abstract

Abstract Although noninfiltrative ophthalmopathy can be seen with hyperthyroxinemia on any basis, infiltrative ophthalmopathy is peculiar to Graves' disease. With infiltrative ophthalmopathy involvement of extraocular motor muscles can cause shortening of the levator palpebrae superiorus and fixed upper eyelid retraction. Paresis of other muscles may cause diplopia or strabismus. Complications of proptosis include corneal damage from exposure and optic nerve injury from traction or compression; from venous engorgement: chemosis, subconjunctival hemorrhage, orbital pain, and glaucoma. Restoration of the euthyroid state improves noninfiltrative ophthalmopathy. For mild infiltrative disease, local and mechanical measures may provide symptomatic relief. Adrenal steroids are indicated for progressive infiltrative ophthalmopathy. The principal indications for surgical intervention are cosmetic, for correction of diplopia, or for decreased vision. For best results, surgery must be properly timed and planned. References 1. Pollard JB: Exophthalmos: Diagnostic challenge—therapeutic enigma. Southern Med J 60:815-818, 1967.Crossref 2. Zacharewicz FA: The ophthalmopathy of hyperthyroidism. GP 36:88-97, 1967. 3. Garber MI: Methylprednisone in the treatment of exophthalmos. Lancet 1:958-960, 1966.Crossref 4. Gay AJ, Wolkstein MA: Topical guanethidine therapy for endocrine lid retraction. Arch Ophthal 76:364-367,1966.Crossref 5. Brown J, Coburn JW, Wigod RA, et al: Adrenal steroid therapy of severe infiltrative ophthalmopathy of Graves' disease. Amer J Med 34:786-795, 1963.Crossref 6. Day RM, Carroll FD: Optic nerve involvement associated with thyroid dysfunction. Trans Amer Ophthal Soc 59:220-238, 1961. 7. Burrow GN, Mitchell MS, Howard RO, et al: Immunosuppressive therapy for the eye changes of Graves' disease. J Clin Endocr 31:307-311, 1970.Crossref 8. Catz B, Perzik SL: Subtotal versus total ablation of thyroid: Malignant exophthalmos and its relation to remnant thyroid , in Cassano C, Andreoli M: Current Topics in Thyroid Research. New York, Academic Press Inc, 1965, p 1183. 9. Pequenat EP, Mayberry WE, McConahey WM, et al: Large doses of radioiodine in Graves' disease: Affect on opthalmopathy and long-acting thyroid stimulator. Mayo Clin Proc 42:802-811, 1967. 10. Werner SC, Feind CR, Aida M: Graves' disease and total thyroidectomy. New Eng J Med 276:132-137, 1967.Crossref 11. Goldstein I: Recession of levator muscle for lagophthalmos in exophthalmic goiter. Arch Ophthal 11:389-393, 1934.Crossref 12. Henderson JW: Relief of eyelid retraction. Arch Ophthal 74:205-216, 1965.Crossref 13. Miller JE, Van Heuven W, Ward R: Surgical correction of hypotropia associated with thyroid dysfunction. Arch Ophthal 74:509-515, 1965.Crossref 14. Long JC: Surgical management of the tropias of thyroid exophthalmos. Arch Ophthal 75:634-638, 1966.Crossref 15. Haddad HM: Needle aspiration of malignant (progressive) endocrine exophthalmos. Arch Ophthal 80:703-704, 1968.Crossref 16. Callahan A: Reconstructive Surgery of the Eyelids and Ocular Adnexa. Birmingham, Ala, Aesculapius Publishing Co, 1966, p 237. 17. Naffziger HC: Progressive exophthalmos. Ann Roy Coll Surg Eng 15:1-24, 1954. 18. MacCarty CS, Kenefick TP, McConahey WM, et al: Ophthalmopathy of Graves' disease treated by removal of roof, lateral walls, and lateral sphenoid ridge: Review of 46 cases. Mayo Clin Proc 45:488-493, 1970. 19. Berke RN: A modified Krönlein operation. Arch Ophthal 51:609-632, 1954.Crossref 20. Sinskey RM: The management of metabolic malignant exophthalmos. Arch Ophthal 66:214-218, 1961.Crossref 21. Kroll AJ, Casten VG: Dysthyroid exophthalmos palliation by lateral orbital decompression. Arch Ophthal 76:205-210, 1966.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1972

There are no references for this article.