DIAGNOSTIC-CRITERIA FOR GRAVES OPHTHALMOPATHY

PURPOSE: To propose criteria for the diagnosis of Graves' ophthalmopat hy. METHODS: We reviewed the evolution of nomenclature describing Grav es' ophthalmopathy and the diagnostic schema used in key published rep orts. RESULTS: A laboratory test or clinical finding pathognomonic for Graves' ophthalmopathy currently is not available or recognized. Exta nt diagnostic criteria may exclude appropriate cases. CONCLUSIONS: Gra ves' ophthalmopathy is considered to be present if eyelid retraction o ccurs in association with objective evidence of thyroid dysfunction or abnormal regulation, exophthalmos, optic nerve dysfunction, or extrao cular muscle involvement, The ophthalmic signs may be unilateral or bi lateral, and confounding causes must be excluded. If eyelid retraction is absent, then Graves' ophthalmopathy may be diagnosed only if exoph thalmos, optic nerve involvement, or restrictive extraocular myopathy is associated with thyroid dysfunction or abnormal regulation and if n o other cause for the ophthalmic feature is apparent.