Visual disturbances are a common occurrence in patients with untreated Graves disease. The en-docrinologist explains to the patient that the main cause of these complications is:
a. decreased blood flow to the eye.
b. orbital edema and protrusion of the eye-ball.
c. TSH neurotoxicity to retinal cells.
d. local lactic acidosis.
ANS: B
Visual disturbances with Graves disease include orbital fat accumulation, inflammation, and edema of the orbital contents resulting in exophthalmos (protrusion of the eyeball), periorbital edema, and extraocular muscle weakness leading to diplopia (double vision).
Blood flow to the eye is not an effect, but visual changes occur. Functional abilities of the eye result from hyperactivity of the sympathetic system. Lactic acid is not involved with visual changes in the eye.
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