Chatziralli Irini P, Kanonidou Evgenia, Keryttopoulos Petros, Papadopoulou Dionyssia, Papazisis Leonidas
Department of Ophthalmology, General Hospital of Veroia, Veroia, Greece.
Case Rep Ophthalmol. 2010 Sep 13;1(2):53-55. doi: 10.1159/000320582.
A 59-year-old female patient presented at the outpatients' Department of Ophthalmology with epiphora, eyelid swelling, and a foreign body feeling in the right eye. The symptoms were present for 4 months, and the patient was treated as suffering from relapsing conjunctivitis. The slit lamp examination revealed keratitis due to exposure, related with the deficient closure of the eyelids. There was a 2 mm difference in the readings with the Hertel exophthalmometry examination between the eyes. Her medical history was clear, and she was referred for computed tomography of the orbits and brain and biochemical examinations (FT(3), FT(4), and TSH) to investigate the presence of an intraorbital mass. FT(3) was significantly increased and TSH was accordingly low, indicating the diagnosis of Graves' disease, which presented without other signs and symptoms apart from ophthalmopathy. Computed tomography scan excluded the diagnosis of an intraorbital mass. Therefore, it is important not to underestimate the ocular manifestations of systemic diseases.
一名59岁女性患者因右眼溢泪、眼睑肿胀及异物感就诊于眼科门诊。这些症状已持续4个月，患者曾被诊断为复发性结膜炎。裂隙灯检查发现暴露性角膜炎，与眼睑闭合不全有关。Hertel眼球突出计检查显示双眼读数相差2mm。她的病史清晰，为排查眶内肿物，她接受了眼眶及脑部计算机断层扫描以及生化检查（FT(3)、FT(4)和TSH）。FT(3)显著升高，TSH相应降低，提示诊断为Graves病，该病除了眼部病变外无其他体征和症状。计算机断层扫描排除了眶内肿物的诊断。因此，不要低估全身性疾病的眼部表现，这一点很重要。
