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Exophthalmos in obesity
M H Smolders1, H S Graniewski-Wijnands, A E Meinders
1Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.
Aims:
To establish the relationship between exophthalmos and obesity.
Methods:
A group of 19 obese patients (body mass index, BMI >/=30 kg/m(2)) was compared with a control group of 45 nonobese individuals (26 > BMI >/= 20 kg/m(2)). Both groups underwent Hertel's exophthalmometry, Goldmann applanation tonometry and measurement of the medial rectus muscle by echography.
Results:
Obese patients had higher Hertel values and enlarged medial rectus muscle diameter (p < 0.05). Indeed, bilateral exophthalmos was observed in 33% of obese subjects. However, this did not cause any ocular morbidity. In some cases the difference in intraocular pressure was enlarged but together with the exophthalmos not statistically significant.
Conclusions:
Standard values for exophthalmometry and orbital echography may have to be adapted for obese individuals. In several cases the eye signs had a remarkable resemblance to patients with Graves' orbitopathy. So in each patient with bilateral exophthalmos and eye signs suspicious of Graves' orbitopathy obesity should be considered as a possible cause.
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