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Graves Ophthalmopathy

 Syn. Thyroid eye disease , Graves orbitopathy , Thyroid-associated ophthalmopathy

Signs & Symptoms

 Foreign object sensation in the eyes
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)]
Impairment of color vision
Note: due to Compression of the optic nerve at the orbital apex
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)] Vaughan [ 604]
Expansion of orbital fat
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)] Vaughan [ 602]
Exacerbated by cigarette smoking
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)] Vaughan [ 602] BCSC [ 42]

Physical Examination

 Unilateral Upper eyelid retraction
Ref: Vaughan [ 602] BCSC [ 40,44]
Upper eyelid retraction
Note: Unilateral or bilateral
Ref: Vaughan [ 602] BCSC [ 40,44]
Bilateral Upper eyelid retraction
Ref: Vaughan [ 602] BCSC [ 40,44]

Lab / Serology

Imagin Study

 Edema of the inferior recti muscles
Ref: Vaughan [ 603]
Edema of the medial recti muscles
Ref: Vaughan [ 603]
Edema of the rectus muscles
Note: Typically the inferior and medial recti
Ref: Vaughan [ 603]

Complication

 Chemosis
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)] BCSC [ 40]
Conjunctival ulceration
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)] BCSC [ 40]
Fibrosis of extraocular muscles
Ref: Vaughan [ 603]

Risk Factors

 Female
Ref: BCSC [ 42]
Smoking
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)]
Elder
Ref: Uptodate [ Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy)]

Cause

Other