University of Iowa Health Care

Ophthalmology and Visual Sciences

EyeRounds Online Atlas of Ophthalmology

Contributor: William Charles Caccamise, Sr, MD,, Retired Clinical Professor of Ophthalmology, University of Rochester School of Medicine and Dentistry

Expanded text by Brendan K. Penaluna, May 5, 2017

*Dr. Caccamise has very generously shared his images of patients taken while operating during the "eye season" in rural India as well as those from his private practice during the 1960's and 1970's. While the quality of his images are not up to today's higher web standards, many of his images are significant for their historical perspective and for techniques and conditions seen in settings in undeveloped areas.

Category: Systemic Disorders

Asymmetrical bilateral exophthalmus

Graves' Disease is the most common cause of exophthalmos in adults and is often asymmetrical. The inferior rectus and medial rectus muscles are more commonly inflamed in patients with Graves' exophthalmos. The swelling of inflamed muscles leads to proptosis, and additionally may cause strabismus. Additionally, dry eye and the risk of optic nerve compression must be addressed.

asymmetrical bilateral exophthalmus

In adults, bilateral exophthalmus is most often related to ophthalmic Graves' disease.


Horton JC. Disorders of the Eye. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e New York, NY: McGraw-Hill; 2014. Accessed April 13, 2017.

originally posted 2/8/2008

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Ophthalmic Atlas Images by, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

last updated: 05-05-2017
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