Upper eyelid retraction and Graves' disease

Ten upper eyelids of patients with lid retraction due to Graves' disease were treated by levator marginal myotomies. The most common clinical abnormalities were thickening and fatty infiltration of the levator, with adhesions to the orbicularis muscle and the orbital septum. Histologic examination of these tissues revealed collagen proliferation, striated muscle atrophy, and fatty infiltration. The technique and usefulness of levator marginal myotomy are described.