VISUAL CHANGES IN PROGRESSIVE EXOPHTHALMOS

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Abstract
PROGRESSVIE exophthalmos is often called "malignant" exophthalmos, and it is sometimes referred to as exophthalmic ophthalmoplegia (Brain12), thyrotropic exophthalmos (Mulvany18), and a hyperophthalmopathic type of Graves's disease (Means16). In contrast to the slight exophthalmos of goiter, which may be combined with some staring, the malignant type is characterized by its progressive nature; periorbital and lid edema; diminution or lack of resiliency, elicited by palpating the eyeball; limitation of ocular motility, often causing diplopia, and retraction of the upper lid, resulting in staring. In some cases thyrotoxicosis precedes this exophthalmos, but usually by the time there are signs of progressive exophthalmos the thyroid condition is well controlled or has reached the stage of hypothyroidism; occasionally there is no thyroid history whatsoever. Fortunately, malignant exophthalmos occurs infrequently, for it is a disabling and dangerous disease and a great burden to the patient, as well as to the physician, particularly

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