Palsy of the extraocular muscles in exophthalmic goitre : with the report of a case / by William Campbell Posey.

  • William Campbell Posey
Date:
[1904]
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Licence: In copyright

Credit: Palsy of the extraocular muscles in exophthalmic goitre : with the report of a case / by William Campbell Posey. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    Extracted from The American Journal of the Medical Sciences, July, 1904 PALSY OF THE EXTRAOCULAR MUSCLES IN EXOPH- THALMIC GOITRE.1 WITH THE REPORT OF A CASE. By William Campbell Posey, M.D., OF PHILADELPHIA. Ln addition to the usual ocular signs which constitute part of the cardinal symptoms of Graves' disease—i. e., the exophthalmus and the so-called Graefe, Stellwag, Dalrymple, and Mobius signs, and which are dependent upon various incoordinations and weak- nesses of certain parts of the nervous mechanism of the eye, actual palsy of one or more of the extrinsic ocular muscles is sometimes met with. The notes of a case of this nature are appended. Sarah L., a housekeeper, aged forty-three years, was brought to the service of the writer at the Polyclinic Hospital by Dr. O. C Heffner, of Pottstown, Pa., in October, 1902, upon account of poor sight of several months' duration. The patient had been in rather poor health for ten years or more, suffering from palpitation of the heart and nervousness, but had had no prolonged or serious illness other than attacks of muscular rheumatism. Her appetite was good and her bowels regular; she still menstruated regularly, though she had always been subject to more or less uterine trouble. She had had seven children, five of whom were living and well; she had had no miscarriages. She said that her sight had always been good until two months before, when she suddenly saw double, the double vision persisting without remission ever since. Though dizzy at times, she did not complain of nausea, nor was she subject to attacks of vomiting. She had suffered considerably from supra- orbital and temporal head pains for several years, which were at times quite violent. She was not aware of ever having had a swelling of the neck. Dr. Heffner had noticed a prominence of the eyes, especially of the left, for several months previously. Upon examination both eyeballs were found to be slightly proptosed, the left being slightly more so than its fellow. As shown in the accompanying photograph, the palpebral fissures were widened, there being about 2 mm. of white ' Read before the Ophthalmologlca! Section of the College of Physicians of Philadelphia, January 19, 1904.
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