Malignant exophthalmos is a pathological entity. It is also described as exophthalmic ophthalmoplegia, progressive exophthalmos, or thyrotropic exophthalmos.
The last name seems to be most suitable, as it indicates not only the disease but also the presumable cause of this condition.
The onset is usually insidious. Patients complain of lacrimation, photophobia, and protrusion of the eyeballs, which may achieve extreme grades. There are swelling and inflammation of the conjunctiva, often associated with prolapse of the conjunctival sac. Defective eye closure causes secondary changes in the cornea.Characteristic are pathological changes in the eye muscles in the form of degeneration of muscle fibers, fragmentation of fibers and round-cell infiltration.The associated muscle palsies mostly involve the rectus superior on one or both sides with diplopia, or without if both sides are involved. Owing to increased volume of the muscles (3 to 8 times that of the normal volume and length)
BIBER JJ. A New Operation for Decompression in Malignant Exophthalmos. AMA Arch Otolaryngol. 1957;66(3):266–270. doi:10.1001/archotol.1957.03830270024004
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