Location (1): Lesions mainly damage levator palpebrae superioris and extraocular muscles, and the common ones are as follows: ① Eyelid retraction, especially upper eyelid retraction, which is characterized by large eyelid dehiscence and exposure of upper cornea and sclera. When the eyeball looks down, the upper eyelid does not move down with the eyeball, which is called eyeball lag. ② Exophthalmos, diplopia and eye movement limitation are mainly caused by extraocular muscle diseases, early hypertrophy and edema, cell infiltration, often accompanied by conjunctival congestion and late degeneration and fibrosis, which limits eye movement. The lower rectus muscle is often involved first, followed by the inner rectus muscle, and then the upper rectus muscle, and the outer rectus muscle is the least involved. Excessive hypertrophy of extraocular muscles can compress the optic nerve at the orbital apex, causing optic nerve damage and even decreased vision. In addition, exophthalmos and eyelid retraction and lag will cause difficulty in eyelid closure, lead to exposure keratitis and corneal ulcer, and seriously threaten vision.
(2) Classification: Type I, mostly female, symmetrical exophthalmos and eyelid retraction, mild inflammation of orbital and extraocular muscles, moderate muscle hypertrophy; Type ⅱ, obvious inflammation of extraocular muscles and orbit, often accompanied by bulbar conjunctival edema, obvious and asymmetric extraocular muscle hypertrophy, often accompanied by compressive optic neuropathy and diplopia.
(3) Diagnostic basis: Diagnosis can be made according to typical clinical eye manifestations. CT examination shows that extraocular muscles are hypertrophy but tendons are not involved, which is helpful for diagnosis.
(2) Treatment principles: eye protective treatment, drug anti-inflammatory treatment, surgical treatment and radiotherapy.