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November 1956

Treatment of Exophthalmos from the Viewpoint of an Internist

Author Affiliations

From the Department of Medicine, Western Reserve University School of Medicine, and University Hospitals.

AMA Arch Ophthalmol. 1956;56(5):671-677. doi:10.1001/archopht.1956.00930040679004

The medical treatment of endocrine exophthalmos (malignant exophthalmos, progressive exophthalmos, metabolic exophthalmos, exophthalmic ophthalmoplegia, or hyperophthalmopathic Graves' disease) has long been more speculative than definitive, as might be expected in a condition whose etiology is not known. Each recommended method of therapy has been reported to have varying degrees of efficacy in different hands, none being beneficial in every case. Evaluation of specific therapeutic measures is difficult because the numbers of cases in reported series are usually small, the criteria used to estimate the severity of the ophthalmopathy and its degree of response to therapy lack uniformity, and therapeutic regimens vary greatly, with several methods of treatment frequently being employed simultaneously. In addition, the possibility of spontaneous remission must be considered. Until more evidence based on uniform observations is available, or until the etiology and pathological physiology of this puzzling disturbance are ascertained, no dogmatic statement regarding its proper definitive