Orbital X-ray Therapy of Progressive Exophthalmos

The clinical features of the special ophthalmopathic type of Graves' disease (designated “progressive exophthalmos”) are distinguished from those of exophthalmic goitre, and the pathology is discussed in relation to the production of proptosis. Important histological features are lymphocytic infiltrations and chronic inflammatory œdematous changes in the orbital tissues; their radiosensitivity forms the basis for orbital X-ray therapy. Clinical improvement has been obtained in the majority of 22 cases of true “progressive exophthalmos” irradiated, but not in seven cases of “thyrotoxic exophthalmos”. The importance is stressed of accurate diagnosis of the type of disorder before undertaking orbital irradiation of any particular case.