Ophthalmic Graves' disease

Ophthalmic Graves' disease is a peculiar clinical condition, characterized by ocular symptoms, without thyrotoxicosis. A survey of 22 observed cases is discussed. This condition is 25 times less frequent than classical Graves' disease. The eye symptoms include upper lid retraction, exophthalmos, and severe ophthalmopathy. Unilateral symptoms are frequent (16 out of 22). A negative T3 suppression test was found in half of the patients. LATS was detectable in 3 out of 17 of the cases. The stimulation of TSH secretion by TRH was normal in 3 out of 6 of the cases. When the tests were combined and repeated, a positive response was found in 8 out of 9 of the exophthalmic patients, and in 3 out of 9 of the patients with lid retraction. Appreciation of the course of the disease necessitates a prolonged follow-up; transformation into classical thyrotoxicosis have been observed. Our clinical studies bring into focus the relationship of ocular symptoms with Graves' disease and Hashimoto's disease.