THE PATIENT who has proptosis of one eye often presents a difficult diagnostic problem, of interest not only to the ophthalmologist, but also to the neurosurgeon and the clinician. That the entire problem of exophthalmos is complex is substantiated by the voluminous literature on the subject. There are many perplexing gaps in the present knowledge of exophthalmos. What is the mechanism or mechanisms of exophthalmos in exophthalmic goiter? What is the exact relationship between the thyroid and the pituitary glands? Why, if exophthalmic goiter is a systemic disease, should proptosis occasionally be apparently limited clinically to one side? Many investigators have shed considerable light on these and other questions, but there is little general agreement on many phases of this problem.
The differential diagnosis of asymmetric exophthalmos is hampered by the lack of a "yardstick" by which to compare the incidence and degree of proptosis in the numerous etiologic conditions
DRESCHER EP, BENEDICT WL. ASYMMETRIC EXOPHTHALMOS. Arch Ophthalmol. 1950;44(1):109-128. doi:10.1001/archopht.1950.00910020112007