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A 2-Year Study on the Temporal Course between Graves' Ophthalmopathy and Graves' Disease among Out-Patients in a Private Tertiary Hospital Queenievic Nathalie Q. Fang, M.D. OBJECTIVES: To determine the temporal relationship between the development of ophthalmic manifestations and the diagnosis of Graves disease in out-patients in a tertiary hospital. To determine the most common signs and symptoms occurring in these patients with Graves' ophthalmopathy. METHODS: Descriptive, retrospective study. Medical records of out-patients, seen at the Ophthalmology Out-Patient department of the University of Santo Tomas Hospital from January 2008 to June 2010, were pulled out, reviewed, and recorded as to what and when the ophthalmic manifestations developed in relation to their diagnosis of Graves' disease. RESULTS: Among 32 patients noted to have Graves' ophthalmopathy, all of them diagnosed with hyperthyroidism, 72% were females and 28% were males. Fifty-nine percent developed signs and symptoms unilaterally, while 41% developed bilateral manifestations. In 33% of patients, they developed manifestations at the time of diagnosis of hyperthyroidism. Twenty-five percent developed Graves' ophthalmopathy within 12 months prior to the diagnosis of Graves' disease, whereas 21% had it within 12 months after they were diagnosed, and 18% more than 12 months after diagnosis of Graves' disease. Common signs noted initially were lid retraction (33%), exophthalmos (27%%), lagophthalmos (18%), increased intraocular pressure on upgaze (16%), ptosis (4%), exotropia (4%), and extraocular muscle limitation (2%). Symptoms commonly noted were foreign body sensation (37%), blurring of vision (30%), tearing (18%), and diplopia (15%). CONCLUSION: We concluded that Graves' ophthalmopathy more commonly developed at the same time as their diagnosis of Graves' disease. The occurrence of ophthalmopathy, together with the systemic manifestations, prompt the patients to seek consult, hence the diagnosis of Graves' disease. Lid retraction was the most common sign, followed by exophthalmos. Foreign body sensation was the most common symptom noted by patients with Graves' disease. |
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