It has been recognized that pathologic changes occur in the extraocular muscles with alterations in thyroid function.1 These may produce hypertropias, cyclotropias, horizontal deviations, and limitations of upward gaze. The present report concerns seven patients with thyroid dysfunction and abnormalities of ocular movement resembling a superior rectus weakness. However, investigation indicated that fibrosis of the inferior rectus and adhesions between the inferior rectus and inferior oblique were the cause of the restriction. Marked improvement of elevation and of diplopia was obtained by dividing the adhesions and recessing the inferior rectus. It is the purpose of this report to present the clinical findings and surgical results obtained in these patients.
All patients had medical, orthoptic, and ophthalmological evaluations including the traction test for limitation of eye movement and electromyography of appropriate eye muscles.
—The necessity of this simple atraumatic test was emphasized by Dunnington and Berke
MILLER JE, van HEUVEN W, WARD R. Surgical Correction of Hypotropias Associated With Thyroid Dysfunction. Arch Ophthalmol. 1965;74(4):509-515. doi:10.1001/archopht.1965.00970040511012