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Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease ) or unilateral (as is often seen in an orbital tumor).
Graves' ophthalmopathy, also known as thyroid eye disease (TED), is an autoimmune inflammatory disorder of the orbit and periorbital tissues, characterized by upper eyelid retraction, lid lag, swelling, redness (), conjunctivitis, and bulging eyes (exophthalmos). [1]
Considering the many signs and symptoms, the generally delayed diagnosis, and the possibility of residual complaints after treatment, it is little wonder that a significant number of people with Graves' disease have difficulty keeping their job. One study found that of 303 patients successfully treated for hyperthyroidism (77% had Graves ...
The diagnosis may be suspected based on symptoms and confirmed with blood tests and radioiodine uptake. [1] [4] Typically, blood tests show a raised T 3 and T 4, low TSH, increased radioiodine uptake in all areas of the thyroid, and TSI antibodies. [4] The three treatment options are radioiodine therapy, medications, and thyroid surgery. [1]
Stellwag's sign is a sign of infrequent or incomplete blinking associated with exophthalmos or Graves orbitopathy. It is accompanied by Dalrymple's sign, which is a retraction of the upper eyelids resulting in an apparent widening of the palpebral opening. Stellwag's sign is named after Austrian ophthalmologist Karl Stellwag von Carion.
Differential diagnosis Graves disease Joffroy's sign is a clinical sign in which there is a lack of wrinkling of the forehead when a patient looks up with the head bent forwards. [ 1 ]
Differential diagnosis Graves-Basedow disease Abadie's sign of exophthalmic goiter is a medical sign characterized by spasm of the levator palpebrae superioris muscle with retraction of the upper lid (so that sclera is visible above cornea ) seen in Graves-Basedow disease which, together with exophthalmos causes the bulging eyes appearance.
Hyperthyroidism, associated with exophthalmos, periorbital puffiness, lid retraction, and lid lag; Cavernous sinus thrombosis, associated with infection of the paranasal sinuses, proptosis, periorbital oedema, retinal haemorrhages, papilledema, extraocular movement abnormalities, and trigeminal nerve sensory loss