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Previous Volume 360:994-1001 March 5, 2009 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 40-year-old woman who recently received a diagnosis of Graves' disease comes for a follow-up visit. She has been taking methimazole, at a dose of 10 mg daily, and is now euthyroid, but for the past 3 months, she has had bothersome eye symptoms, including redness, tearing, grittiness, photophobia, diplopia at the extremes of gaze, and ocular pain with eye movements. She . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnosis

Evaluation

Management

            Glucocorticoid Therapy

            Orbital Radiotherapy

            Other Possible Pharmacologic Treatments

            Surgery

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Department of Clinical Medicine, University of Insubria, Varese, Italy.

An audio version of this article is available at NEJM.org.

Address reprint requests to Dr. Bartalena at the Department of Clinical Medicine, University of Insubria, Division of Endocrinology, Ospedale di Circolo, Viale Borri, 57, 21100 Varese, Italy, or at luigi.bartalena@uninsubria.it.

This article has been cited by other articles:

• Estcourt, S., Hickey, J., Perros, P., Dayan, C., Vaidya, B. (2009). The patient experience of services for thyroid eye disease in the United Kingdom: results of a nationwide survey. Eur J Endocrinol 161: 483-487 [Abstract] [Full Text]