Clinical evaluation of Graves ophthalmopathy in north-east Islamic Republic of Iran

This study evaluated the prevalence and severity of ophthalmic manifestations in all Graves disease patients [n = 68] presenting to endocrine clinics at Mashad University of Medical Sciences between December 2002 and September 2005. The mean age of patients was 38.0 [SD 14.0] years, range 15 to 71 years. The most common complaints were foreign body sensation [54.0%] and puffy eyelids [48.4%]. The most common apparent abnormality was lid retraction in 64.2% of patients [bilateral in 95.3% of cases]. The patients had a mean modified Werner's NO SPECS classification score of 3.00 [SD 1.46]. The score was significantly higher in males than females [3.58 [SD 1.44] versus 2.63 [SD 1.35]] and was positively correlated with age

Severe photophobia in a teenager with APECED syndrome

Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy [APECED] syndrome is a rare, but well-known cause of chronic keratoconjunctivitis with early onset. Patient: A 15 year-old boy with APECED syndrome, who was referred to our hospital because of intense photophobia and blepharospasm. On clinical examination the patient had severe keratitis accompanied by iridocyclitis. The patient showed dramatic response to topical corticosteroids and cycloplegics. Chronic bilateral keratitis is an ocular manifestation of APECED. When an ophthalmologist is confronted with a young child or adolescent and bilateral chronic keratitis with symptoms of intense photophobia, blepharospasm, lacrimation and either with mucocutaneous candidiasis or hypoparathyroidism, APECED is a disease of consideration and appropriate investigation should be done