clinical features
Last reviewed 08/2021
- 5-10% cases are unilateral
Presentation may include:
- orbital pain
- lacrimation
- photophobia
- blurred or double vision
Features found on examination may include:
- proptosis - usually bilateral, often asymmetric; less commonly, symmetrical
- lid retraction and lid lag
- periorbital puffiness
- impaired extraocular muscle function
- chemosis - conjunctival oedema - and injection
- exposure keratitis; possibly, corneal ulceration
- ophthalmoplegia - generally superior rectus producing diplopia maximal on upward and outward gaze
- reduced visual acuity
- papilloedema; optic atrophy
- pretibial dermopathy (the least common manifestation of Grave's disease) occurs in patients with severe ophthalmology - generally occurs as a nodular or diffuse thickening of the skin of the anterior lower leg, but it can occur elsewhere.