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Surgical Correction of Hypotropias Associated With Thyroid Dysfunction

Surgical Correction of Hypotropias Associated With Thyroid Dysfunction Abstract Introduction It has been recognized that pathologic changes occur in the extraocular muscles with alterations in thyroid function.1 These may produce hypertropias, cyclotropias, horizontal deviations, and limitations of upward gaze. The present report concerns seven patients with thyroid dysfunction and abnormalities of ocular movement resembling a superior rectus weakness. However, investigation indicated that fibrosis of the inferior rectus and adhesions between the inferior rectus and inferior oblique were the cause of the restriction. Marked improvement of elevation and of diplopia was obtained by dividing the adhesions and recessing the inferior rectus. It is the purpose of this report to present the clinical findings and surgical results obtained in these patients. Evaluation All patients had medical, orthoptic, and ophthalmological evaluations including the traction test for limitation of eye movement and electromyography of appropriate eye muscles. Traction Test. —The necessity of this simple atraumatic test was emphasized by Dunnington and Berke References 1. Naffziger, H.C.: Pathologic Changes in Orbit in Progressive Exophthalmos With Special Reference to Alterations in Extraocular Muscles and Optic Discs , Arch Ophthal 9:1, 1933.Crossref 2. Dunnington, J.H., and Berke, R.N.: Exophthalmos Due to Chronic Orbital Myositis , Arch Ophthal 30:446, 1943.Crossref 3. Miller, J.E.: Electromyographic Pattern of Saccadic Eye Movements , Amer J Ophthal 46:183, 1958. 4. Wigelius, O., et al: Retrobulbar Connective Tissue Changes in Malignant Exophthalmos , Acta Endocrinol 25:452, 1957. 5. Werner, S.C.: Euthyroid Patients With Early Eye Signs of Graves' Disease , Amer J Med 18:608, 1955.Crossref 6. Goldstein, J.E.: Paresis of Superior Rectus Muscle , Arch Ophthal 72:5, 1964.Crossref 7. Pimstone, B.L., et al: Parallel Assays of Thyrotrophin, Long-Acting Thyroid Stimulator and Exophthalmos-Producing Substance in Endocrine Exophthalmos and Pretibial Myxedema , J Clin Endocr 24:976, 1964.Crossref 8. Brain, W.R.: Exophthalmic Ophthalmoplegia , Quart J Med 7:293, 1938. 9. Miller, J.E.: Acquired Strabismus in Adults , Southern Med J 54:744, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Surgical Correction of Hypotropias Associated With Thyroid Dysfunction

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1965.00970040511012
Publisher site
See Article on Publisher Site

Abstract

Abstract Introduction It has been recognized that pathologic changes occur in the extraocular muscles with alterations in thyroid function.1 These may produce hypertropias, cyclotropias, horizontal deviations, and limitations of upward gaze. The present report concerns seven patients with thyroid dysfunction and abnormalities of ocular movement resembling a superior rectus weakness. However, investigation indicated that fibrosis of the inferior rectus and adhesions between the inferior rectus and inferior oblique were the cause of the restriction. Marked improvement of elevation and of diplopia was obtained by dividing the adhesions and recessing the inferior rectus. It is the purpose of this report to present the clinical findings and surgical results obtained in these patients. Evaluation All patients had medical, orthoptic, and ophthalmological evaluations including the traction test for limitation of eye movement and electromyography of appropriate eye muscles. Traction Test. —The necessity of this simple atraumatic test was emphasized by Dunnington and Berke References 1. Naffziger, H.C.: Pathologic Changes in Orbit in Progressive Exophthalmos With Special Reference to Alterations in Extraocular Muscles and Optic Discs , Arch Ophthal 9:1, 1933.Crossref 2. Dunnington, J.H., and Berke, R.N.: Exophthalmos Due to Chronic Orbital Myositis , Arch Ophthal 30:446, 1943.Crossref 3. Miller, J.E.: Electromyographic Pattern of Saccadic Eye Movements , Amer J Ophthal 46:183, 1958. 4. Wigelius, O., et al: Retrobulbar Connective Tissue Changes in Malignant Exophthalmos , Acta Endocrinol 25:452, 1957. 5. Werner, S.C.: Euthyroid Patients With Early Eye Signs of Graves' Disease , Amer J Med 18:608, 1955.Crossref 6. Goldstein, J.E.: Paresis of Superior Rectus Muscle , Arch Ophthal 72:5, 1964.Crossref 7. Pimstone, B.L., et al: Parallel Assays of Thyrotrophin, Long-Acting Thyroid Stimulator and Exophthalmos-Producing Substance in Endocrine Exophthalmos and Pretibial Myxedema , J Clin Endocr 24:976, 1964.Crossref 8. Brain, W.R.: Exophthalmic Ophthalmoplegia , Quart J Med 7:293, 1938. 9. Miller, J.E.: Acquired Strabismus in Adults , Southern Med J 54:744, 1961.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Oct 1, 1965

References