Basedow syndrome (graves disease; hyperthyroidism; thyrotoxicosis; exophthalmic goiter; parry disease)    125

General: Diffuse toxic goiter; inherited as a simple autosomal recessive; penetrance greater in females; however, dominant mode of inheritance and variable penetrance are possible; uncommon in either sex before age 15 years.

Ocular: Exophthalmos; swelling of eyelids and discoloration of upper eyelids; lid lag (von Graefe); globe lag (Koeber); lid trembling on gentle closure (Rosenbach sign); reduced blinking (Stellwag); retraction of upper lid; difficulty in everting upper lid (Gifford sign); convergence weakness (Möobius); impaired fixation on extreme lateral gaze (Suker); possible external ophthalmoplegia (Ballet); Dalrymple sign (staring appearance); tearing; photophobia; epiphora; prolapse of lacrimal gland; neuroretinal edema; tortuous vessels; papilledema and papillitis; anisocoria; keratitis; increased intraocular pressure; increased intraocular pressure on upgaze; decreased visual acuity; enlargement of the extraocular muscles; increased volume of the extraorbital fat; superior rectus muscle enlargement; decreased venous outflow.

Clinical: Tachycardia; anxiety; insomnia; loss of weight; hyperhidrosis; restlessness; myocarditis (toxic); atrial fibrillation.

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