Graves' disease is the most common cause of unilateral exophthalmos, and is by far the most common cause of bilateral exophthalmos. The present ultrasonographic study is based on a series of 20 patients with eye changes of Graves' disease, classes 1 through 6. The B-scan ultrasonographic findings in this condition have not been previously described. B-scan ultrasonography can often demonstrate the inflammatory changes which occur in orbital fat and extraocular muscles in active eye changes of Graves' disease, allowing differentiation from expanding orbital neoplastic lesions and obviating the need for orbital biopsy.
Coleman DJ, Jack RL, Franzen LA, Werner SC. High Resolution B-Scan Ultrasonography of the OrbitV. Eye Changes of Graves' Disease. Arch Ophthalmol. 1972;88(5):465-471. doi:10.1001/archopht.1972.01000030467001