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March 1948


Arch Intern Med (Chic). 1948;81(3):364-368. doi:10.1001/archinte.1948.00220210118011

THE GREAT majority of patients with thyrotoxicosis and exophthalmos appear to have recession of the exophthalmos after a satisfactory subtotal thyroidectomy. However, careful observation of the eyes of these patients with exophthalmometer measurements made before and after thyroidectomy1 reveals that this appearance is misleading. Actually the protrusion of the eyeballs increases after thyroidectomy in 751a to 97 per cent1b of the patients, but the disappearance of retraction of the lids and of associated eye signs gives the erroneous impression that the exophthalmos has been relieved.

It has been observed by Soley1a that progression of exophthalmos in patients with thyrotoxicosis was followed by intensification of the exophthalmos in 37 per cent fewer cases after roentgen therapy than after thyroidectomy. This decreased incidence was thought to be due to a slower return of the endocrine imbalance, present in thyrotoxicosis, to the normal balanced state. Since patients with