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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 5-10% cases are unilateral

Presentation may include:

  • orbital pain
  • lacrimation
  • photophobia
  • blurred or double vision

Features found on examination may include:

  • proptosis - usually bilateral, often asymmetric; less commonly, symmetrical
  • lid retraction and lid lag
  • periorbital puffiness
  • impaired extraocular muscle function
  • chemosis - conjunctival oedema - and injection
  • exposure keratitis; possibly, corneal ulceration
  • ophthalmoplegia - generally superior rectus producing diplopia maximal on upward and outward gaze
  • reduced visual acuity
  • papilloedema; optic atrophy
  • pretibial dermopathy (the least common manifestation of Grave's disease) occurs in patients with severe ophthalmology - generally occurs as a nodular or diffuse thickening of the skin of the anterior lower leg, but it can occur elsewhere.

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