Graves' thyroid disease is a relatively common disorder in endocrinology and general internal medicine practice. Graves' hyperthyroidism is mediated by circulating stimulating autoantibodies. Up to 60% of patients with Graves' hyperthyroidism develop some form of Graves' orbitopathy. Immune reactivity to the thyroid-stimulating hormone receptor is also thought to play a role in the immunopathog...

Once the diagnosis of thyroid eye disease has been made the doctor's problems begin because the management is long term with a condition that has many ramifications over a period of years. Short-term heroics to save vision by use of high-dose systemic steroids, orbital decompression or radiotherapy may have to be followed by control of diplopia by muscle surgery and prisms. Lid retraction, both...

Graves' disease is usually diagnosed as a syndrome of clinical and biochemical features including ophthalmopathy (TAO); the latter occurring in up to 50% of patients with the syndrome. The incidence of TAO is higher in females than in males, as with the parent syndrome (16:2.9 cases per 100 000 people annually). Onset is later in males, who also tend to have more severe cases and poorer prognos...

BACKGROUND A chief morbidity of Graves eye disease is upper eyelid retraction that results in exposure keratopathy and cosmetic deformity. OBJECTIVE To assess the efficacy of graded anterior blepharotomy to treat upper eyelid retraction. METHODS Fifty eyelids of 32 patients with Graves eye disease-associated upper eyelid retraction, causing symptomatic ocular exposure, were treated with gra...

Eyelid involvement is common in facial burns. Ocular sequelae, including corneal ulceration, are usually preventable and secondary to the development of eyelid deformities, exposure keratopathy, and rarely, orbital compartment syndrome. Early ophthalmic review and prophylactic ocular lubrication is mandatory in burns involving the eyelids. Early surgical intervention, often requiring repeat pro...

Lesions affecting the dorsal midbrain can result in a constellation of ocular findings such as vertical gaze disturbances, convergence retraction nystagmus, light-near dissociation of pupils, and eyelid retraction. Although bilateral superior oblique palsy can occur after a stroke, its occurrence secondary to nontraumatic brainstem hemorrhage is extremely rare. We report a combination of dorsal...

In patients with thyroid disease, ocular involvement or thyroid ophthalmopathy is common, irrespective of their thyroid status. A common feature of thyroid eye disease is eyelid retraction, which leads to a classical starry gaze (Kocher sign). Treatment with radioactive iodine (RAI) is a known therapy for hyperthyroidism. However, this treatment may lead to or worsen thyroid ophthalmopathy. We ...

This study evaluated the prevalence and severity of ophthalmic manifestations in all Graves disease patients (n = 68) presenting to endocrine clinics at Mashad University of Medical Sciences between December 2002 and September 2005. The mean age of patients was 38.0 (SD 14.0) years, range 15 to 71 years. The most common complaints were foreign body sensation (54.0%) and puffy eyelids (48.4%). T...

OBJECTIVE To compare patients' acceptance of and correlate their pain level for bimanual versus metal speculum fixation in intravitreal injections. DESIGN Prospective analysis. PARTICIPANTS Seventy-three eyes of 56 patients. METHODS A questionnaire indicating patients' discomfort and pain grading immediately after intravitreal injections using either bimanual fixation or metal speculum fi...

Adrenergic blocking agents have had an occasional and limited use in ophthalmology for several years but are now being used with increasing frequency in the treatment of glaucoma and of the eye signs of accompanying thyroid dysfunction. Several trials of the therapeutic uses of local adrenergic blocking agents have been made and these indicate that, of the agents tested (including Bethanidine, ...