Upgaze intraocular pressure changes and strabismus in Graves' ophthalmopathy

Graves' thyroid ophthalmopathy primarily affects women in their third through sixth decade. Sixty-seven patients with clinical myopathic ophthalmic Graves' disease examined (by SCB) between 1982 and 1989 were measured for changes in upgaze intraocular pressure and strabismus. Special attention was paid to "masquerade" symptoms, including pseudosuperior oblique palsies and cyclotorsions. Any correlation between the extent of hypertropia on muscle exam and upgaze intraocular pressure changes is examined. Data suggest that significant changes in introcular pressure in upgaze correlate with more severe extraocular muscle involvement, may represent progression to muscle fibrosis, and occur uniformly in our study of patients who progress to require inferior rectus recession.