[Severe endocrine ophthalmopathy. A review with case reports]

The autoimmune pathogenesis of endocrine ophthalmopathy (EO) is only partly elucidated. About 40% of all patients with Graves' disease have clinically overt ophthalmopathy. 5% of all Graves' disease patients develop severe EO, independently of the treatment modality for thyrotoxicosis (radioiodine, surgery, antithyroid drugs) and require multidisciplinary treatment. In cases where glucocorticoid treatment is unsuccessful, orbital decompression, as described by Walsh and Ogura, should be considered.