[Tonometry in the diagnosis of subclinical ophthalmopathy in patients with Basedow's disease]

Ophthalmopathy in addition to hyperthyreosis with goitre and dermopathy is characteristic of Basedow's exophthalmos is frequently associated with elevated intraocular pressure (IOP) on upgaze. We wanted to examine whether these changes of IOP exist in patients with Basedow's disease without clinical manifestations of ophthalmopathy. We measured IOP with Goldmann's applanation tonometry in two positions: the primary position, when the patient looks straight ahead and then on upgaze. Forty-six patients with Basedow's disease were examined. The minority [5 (11%)] of the 46 patients had exophthalmos and 22 (47%) of them had abnormal IOP (delta IOP greater than or equal to 3 mmHg). The average interval between the onset of Basedow's disease and this study was 12.8 +/- 7.4 years for those patients who had exaggerated positional changes in IOP, as compared with 5.8 +/- 3.3 years for those with normal IOP, P less than 0.01. We conclude that Basedow's ophthalmopathy is more common than is recognized clinically and that ophthalmopathy is more frequent in patients suffering of Basedow's disease for a longer period. Measuring IOP in two positions is a very simple method which could help us in early diagnosis of ophthalmopathy in patients with Basedow's disease.