Management of eye movement restriction (particularly vertical) in dysthyroid myopathy

Sixteen cases of vertical rectus muscle myopathy in dysthyroid patients are described. In mild cases without diplopia prisms may be adequate treatment. When uncomfortable diplopia is present surgery is indicated when the muscle dysfunction has become stable. Even after surgery further contracture is often experienced, particularly after Ogura antral decompression. The amount of correction obtained by recession of a contracted muscle is greater than that following ordinary strabismus surgery so that usually only one muscle should be operated upon at a time. Care should be exercised in tenotomy of severely contracted muscles. The prognosis is excellent in dysthyroid myopathy if the patient permits the required number of surgical procedures which may be necessary.