Hyperthyroidism Difference between benign proptosis and malignant proptosis

  1.Simple proptosis 2.Infiltrative proptosis No obvious symptoms; photophobia, lacrimation, foreign body sensation, repeated blinking.  The degree of proptosis is mostly <18mm; mostly >18mm. Eye movement is mostly unaffected; Involvement is firstly internal aggregation and secondly abduction.  Features of proptosis Bilateral symmetry; with hyperthyroidism.  Unilateral or asymmetric (>3mm difference); may not be associated with hyperthyroidism, not parallel to hyperthyroidism treatment.  Pathologic basis Sympathetic excitation, spasm of extraocular muscles and epiglottis; deposition of retrobulbar mucopolysaccharide, fibrinogen, lymphocytes, etc., and thickening of ocular muscles.  CT of the orbit is not abnormal; there is a posterior bulb infiltration, widening of the extraocular muscles, irregularity, etc.  Treatment Anti-methyl drugs; Anti-methyl + immunosuppressive diuretics, etc.