You are asked by your professor to make a diagnosis in a 33-year-old woman merely
by looking at her picture (see below). You are promised an "A" in his course if you
make the correct diagnosis.
DIAGNOSIS: Graves ophthalmopathy (GO). GO may be associated with a feeling of grittiness
and discomfort in the eyes, retrobulbar pressure or pain, eyelid lag or retraction,
periorbital edema, chemosis, scleral injection, exophthalamos (proptosis), extraocular
muscle dysfunction, exposure keratitis, and optic neuropathy.
The presented case has periorbital edema which has masked the presence of other eye
signs including those associated with lid retraction (see "Graves disease" in the
Medical Mystery site's archives).
Note the striking periorbital and eyelid edema in this Graves disease patient. The edema has masked other eye signs of Grave's disease including lid retraction signs.
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