PREVALENCE, NATURAL HISTORY AND SURGICAL TREATMENT OF EXOPHTHALMOS

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Abstract
The 95% confidence limits of exophthalmometer measurements have been defined by a single observer in 105 individuals who had no known thyroid disease, and found to be 10.5-18.8 mm. Measurements in 308 patients with thyrotoxicosis have shown that exophthalmos (> 19 mm) of one or both eyes was present in 21.3% of the patients. Among the 122 thyrotoxic patients whose exophthalmometer measurements could be performed annually for 3-19 years after correction of the thyrotoxicosis (usually with 131I), exophthalmos remained stable in 78.7%, worsened in 15.6% and became less severe in 5.7% of the patents. Transurethral decompression of the orbits was performed in 15 patients with rapid subjective improvement in all and reduction in exophthalmometer measurements of 3.6 .+-. 0.5 (mean .+-. SEM) mm, and no serious side-effects. In view of these findings, transantral decompression should be considered more frequently in the treatment of severe or cosmetically damaging exophthalmos.