We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Surgical Approach to the Ophthalmopathy of Graves' Disease

Joseph Ogura, MD; Stanford Wessler, MD; Louis V. Avioli, MD
JAMA. 1971;216(10):1627-1631. doi:10.1001/jama.1971.03180360073011.
Text Size: A A A
Published online


Dr. Steven Raffin, Senior Assistant Resident in Medicine, Jewish Hospital of St. Louis, and Assistant in Medicine, Washington University School of Medicine: A 35-year-old white woman was hospitalized with a nine-month history of progressive "eye swelling," visual loss bilaterally, and frontal headaches. One year prior to admission, the diagnosis of hyperthyroidism had been established and subtotal thyroidectomy performed. The patient had been followed up subsequently in the outpatient clinic and continued to maintain the post-operative euthyroid state without supplemental thyroid medication. The most recent serum protein-bound iodine value, obtained one week prior to admission, was 4.5 μg/100 ml.

Physical examination revealed a well-developed woman in moderate distress. The blood pressure was 178/120 mm Hg; pulse rate was 76 beats per minute and regular, and respiratory rate was 18 per minute. The most striking findings were severe, bilateral papilledema, corneal ulcerations, proptosis, conjunctival edema, and chemosis (Fig 1, right). Also apparent


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.