ABSTRACT
Among 50% of patients with hyperthyroidism develop manifestations of ophthalmopathy and there are between 2% and 5% with severe Graves' ophthalmopathy. The optic neuropathy is a complication of Graves' disease and can be very dangerous for the visual acuity and the treatment must be very fast. We report two cases of severe Graves' ophthalmopathy observed in two black patients from Martinique (French West Indies). Orbital irradiation can be choosed after initial unsuccessful treatment with corticotherapy and before a surgical decompression. These three therapeutics can be combined together according to the results of the treatment and require a real coordination between ophthalmologists, endocrinologists and radiotherapeutists as well as a good cooperation from the patient himself.
Subject(s)
Graves Disease/complications , Optic Nerve Diseases/etiology , Aged , Combined Modality Therapy , Eye Diseases/classification , Eye Diseases/etiology , Eye Diseases/therapy , Female , Graves Disease/therapy , Humans , Middle Aged , Optic Nerve Diseases/classification , Optic Nerve Diseases/therapyABSTRACT
We report three cases of isolated medial orbital wall blow out fracture with medial rectus entrapment. Few cases have been reported in the literature, predominantly in black people as in this paper. Predominance of this rare fracture in black population could be explained by an anatomic hypothesis based on racial origin. The diagnosis is often suggested by the medial rectus entrapment. Depending on the position of the incarceration in front of or behind the equator of the eyeball, the eye presents pseudo-Duane syndrome or exotropia with decreased adduction. The diagnosis is established by orbital computed tomography visualizing the lamina papyracea of the ethmoid bone fracture and the medial rectus incarceration. This exceptional fracture must be detected to avoid complications: enophthalmos and motility disturbances.
