Table 1

Signs and symptoms of Graves ophthalmopathy

Symptoms
 Eye irritation
 Gritty sensation in the eye
 Dryness
 Epiphora (excessive lacrimation)
 Visual blurring
 Diplopia
 Discomfort behind the eye
 Pain on eye movement
 Photophobia
 Vision loss
Signs
 Periorbital and eyelid edema
 Conjunctival erythema
 Chemosis (conjunctival edema)
 Punctate epithelial erosions
 Superior limbic keratoconjunctivitis
 Upper eyelid retraction
 Lower lid retraction exaggerated by exophthalmos leads to scleral show
 Lagophthalmos (failure of the eyelids to protect the eye)
 Proptosis
 Ophthalmoplegia (paralysis of the eye muscles)
 Restrictive hypotropia and esotropia
 Loss of colour vision and perception (optic neuropathy)
 Papilledema (optic neuropathy)