EXTRAOCULAR-MUSCLE PROBLEMS IN THYROID EYE DISEASE

In this paper methods of visualisation of the extraocular muscle chang es in thyroid eye disease are discussed. The histopathology of extraoc ular muscle biopsies has been studied by both light and electron micro scopy to show the type of cellular infiltration and the amorphous mate rial in the extracellular matrix. A series of questions to which answe rs have not yet been found concerning thyroid eye disease are posed wh ich may help to direct new research projects. Finally in the last part of the paper, the surgical results in a series of 41 patients having ocular muscle surgery for diplopia and/or compensatory head postures d ue to thyroid eye disease are described. The conclusions drawn from th ese results are that one should maintain the patient euthyroid, establ ish by orthoptic measurements that the ocular movements have been stab le for at least 6 months, treat by recessing tight muscles using adjus table sutures, and aim to undercorrect the vertical deviation at the t ime of adjustment.