We would like to be able to "do something" to relieve the anxiety and physical distress of patients with the ocular changes of autoimmune disease associated with dysthyroid states. But, practically from its first descriptions,1,2 Graves' disease has frustrated internists, endocrinologists, ophthalmologists, general surgeons, and immunologists, alike. It is enigmatic by what mechanisms the thyroid gland and ocular tissues interact to produce the complex tissue manifestations and often erratic temporal course and in what ways the clinician may modify these interactions or usefully enhance eventual anatomic outcome.
See also pp 1469 and 1473.
Even the terms applied to this condition reflect the uncertainties of etiology, management, and prognosis. This disorder has been variously labeled Graves' ophthalmopathy, infiltrative ophthalmopathy, congestive ophthalmopathy, thyroid eye disease, the eye changes of Graves' disease, malignant exophthalmos, endocrine exophthalmos, and dysthyroid ophthalmopathy. McKenzie3 provides the most pragmatic current definition of Graves' disease: a
Glaser JS. Graves' Ophthalmopathy. Arch Ophthalmol. 1984;102(10):1448-1449. doi:10.1001/archopht.1984.01040031168010