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August 1985

Graves' Ophthalmopathy

Author Affiliations

Ann Arbor, Mich

Arch Ophthalmol. 1985;103(8):1110. doi:10.1001/archopht.1985.01050080022005

To the Editor.  —The editorial entitled "Graves' Ophthalmopathy," by Joel S. Glaser, MD, in the October issue of the Archives1 raises some important questions regarding orbital irradiation but, unfortunately, presents authoritative-sounding answers that are only the author's opinion.Among the questions he raises are the following: "Is a lesser degree of diplopia a worthwhile objective? Has orbital irradiation ever succeeded in curing the incomitant [noncomitant] diplopia caused by the restrictive myopathy of Graves' ophthalmopathy?" Let me present a case that provides a different answer than Dr Glaser's.

Report of a Case.  —In April 1982,I saw a 36-year-old woman who was developing restriction in her right superior rectus and right levator muscles. In three months, she had gone from being orthophoric in primary gaze and having 3 Δ of right hypertropia in downgaze at 3 m to having 3 Δ of intermittent right hypertropia in primary gaze and 12