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

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Title Journal of Neuro-Ophthalmology, December 2008, Volume 28, Issue 4
Date 2008-12
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6bs1z7n
Setname ehsl_novel_jno
ID 225764
Reference URL https://collections.lib.utah.edu/ark:/87278/s6bs1z7n

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Title Ocular misalignment in Graves disease may mimic that of superior oblique palsy.
Creator Vicki M. Chen, Linda R. Dagi
Affiliation Department of Ophthalmology, Children's Hospital Boston, Boston, Massachusetts, USA.
Abstract BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Although a positive TST occurs frequently in Graves disease, other clinical features should allow distinction from superior oblique palsy in most patients.
Subject Adult; Older people; Diagnosis, Differential; Diagnostic Errors; Eye Movements; Eyelids; Female; Graves Disease; Humans; Male; Middle Older people; Oculomotor Muscles; Retrospective Studies; Strabismus; Trochlear Nerve Diseases; Young Adult
OCR Text Show
Format application/pdf
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
Setname ehsl_novel_jno
ID 225749
Reference URL https://collections.lib.utah.edu/ark:/87278/s6bs1z7n/225749
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