The pathogenesis of the ophthalmoplegia occurring in certain endocrine disorders has been subject to debate since Brain first coined the term "exophthalmic ophthalmoplegia" in 1938.1 In his original description Brain1 stated that thyrotoxicosis plays no essential role in ophthalmoplegia. In fact, the presence of impaired ocular motility associated with endocrine exophthalmos was thought to be evidence sufficient to rule out Graves' disease. However, in a recent review2 of his last 50 cases of exophthalmic ophthalmoplegia he reported that 23 were thyrotoxic, 24 were euthyroid, and 3 hypothyroid. In all, 41 of the 50 either had had thyrotoxicosis or did have it at the time of examination.This paper is a report of observations relating to external ophthalmoplegia and exophthalmos where these conditions have been associated with thyrotoxicosis. In addition, the relationship of ophthalmoplegia to proptosis is noted in patients without thyrotoxicosis who were considered to have
SCHULTZ RO, VAN ALLEN MW, BLODI FC. Endocrine Ophthalmoplegia: With an Electromyographic Study of Paretic Extraocular Muscles. AMA Arch Ophthalmol. 1960;63(2):217–225. doi:10.1001/archopht.1960.00950020219003
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