Ocular misalignment in Graves disease may mimic that of superior oblique palsy

Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
Vicki M Chen, Linda R Dagi

Abstract

The Parks-Bielschowsky three-step test (TST) can incorrectly indicate that a superior oblique muscle is paretic in patients with restrictive strabismus. Although this pitfall in diagnosis has been widely reported, no large studies have examined the incidence of a positive TST in patients with Graves disease. We performed a retrospective chart review of 31 consecutive patients with Graves orbitopathy examined at Children's Hospital of Boston from 2003 to 2007. We analyzed ocular ductions, misalignment, and torsion, and thyroid function studies. Six (20%) of the patients had a positive TST, 3 (10%) of which showed excyclotorsion in at least one eye. However, of the 6 patients, 5 had obvious ocular adnexal signs of Graves disease and 2 had obvious supraduction deficits, leaving only 1 (3%) patient in whom the clinician would have mistakenly diagnosed a superior oblique palsy. Although a positive TST occurs frequently in Graves disease, other clinical features should allow distinction from superior oblique palsy in most patients.

References

Mar 1, 1972·American Journal of Ophthalmology·W M Caygill
Sep 1, 1983·Survey of Ophthalmology·H S Metz
May 1, 1984·Archives of Ophthalmology·J D Trobe
Dec 1, 1958·A.M.A. Archives of Ophthalmology·M M PARKS
Jun 15, 2007·Acta Ophthalmologica Scandinavica·Suna TianGunnar Lennerstrand

❮ Previous
Next ❯

Citations

Jun 12, 2012·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Jonathan M HolmesElizabeth A Bradley
Nov 24, 2019·Ophthalmology·Linda R DagiHilda Capo
Nov 19, 2020·Case Reports in Ophthalmological Medicine·Keiichi Aomatsu, Shunji Kusaka
Dec 19, 2020·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Kaveh Vahdani, Geoffrey E Rose

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Neepa M ThackerA L Rosenbaum
The British Journal of Ophthalmology
K ChatzistefanouM N Moschos
Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Jonathan M HolmesDavid A Leske
© 2021 Meta ULC. All rights reserved