Graves Ophthalmopathy

Graves Ophthalmopathy: constellation of findings, apparent in 25-50% of patients with Graves disease.

  • Pathopysiology: oedema and lymphocytic infiltration of orbital fat, connective tissue, and eye muscles.
  • Clinical symptoms: eye discomfort, ‘gritty‘ eye sensation, excessive lacrimation and diplopia.
  • Clinical findings include exophthalmos; eye-lid oedema; eye movement limitation, and conjunctival chemosis/injection.
  • Clinical risk: Optic neuropathy – best predicted by lid edema and limitation of eye movements (NOT proptosis, as intraocular pressure is relieved by the outward protrusion)


History

1835 – Robert James Graves described a clinical spectrum associated with exophthalmic goitre (Graves disease)

1969 – Werner first attempted to classify the changes associated with Graves ophthalmopathy.

1977 – Werner and the American Thyroid Association reviewed and modified the original classification with NO SPECS mnemonic. [1977 May;83(5):725-727]

The problem of nomenclature of the eye changes of toxic diffuse goiter (Graves’ disease, Basedow’s disease, Parry’s disease) remains an unsettled one. Descriptive terms have filled the literature and new ones continue to appear…such as endocrine exophthalmos, infiltrative ophthalmopathy, progressive exophthalmos, malignant exophthalmos and so on. ..a committee of the American Thyroid Association finalized, a classification of the eye changes of Graves’ disease.‘ [Werner 1969 Oct;68(4):646-648]


Graves Ophthalmopathy

Associated Persons


Alternative names

  • Eye changes of Graves disease
  • Thyroid-associated ophthalmopathy (TAO)
  • Thyroid eye disease (TED)

References


eponymictionary CTA 2

eponymictionary

medical etymology

Posted by Dr Mike Cadogan

Emergency physician with a passion for medical informatics and medical education/textbooks. Asynchronous learning #FOAMed evangelist | @sandnsurf | + Mike Cadogan | LinkedIn

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