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Thyroid ophthalmopathy presenting as superior oblique paresis
M L Moster1, T M Bosley, M L Slavin
1Department of Neurology, Temple University School of Medicine, Philadelphia, PA.
Journal of Clinical Neuro-Ophthalmology
|June 1, 1992
Summary
Thyroid ophthalmopathy can initially mimic superior oblique paresis. Early motility defects may stem from inferior rectus muscle restriction, offering diagnostic clues.
Area of Science:
- Ophthalmology
- Endocrinology
Background:
- Thyroid ophthalmopathy (TO) can present with motility disturbances.
- Early diagnosis of TO is crucial for effective management.
Observation:
- Six patients with TO initially showed signs resembling unilateral superior oblique paresis on the three-step test.
- These motility defects preceded more typical TO manifestations.
Findings:
- The early motility defect in TO may be a restrictive process involving the inferior rectus muscle.
- Diagnostic clues include increased vertical deviation and intraocular tension in upgaze, and absence of excyclodeviation.
Implications:
- These findings suggest reassessing diagnostic criteria for isolated superior oblique paresis.
- Considering TO in the differential diagnosis of apparent superior oblique paresis is important.