Certified Ophthalmic Medical Technologist (COMT) Practice Exam

Which of the following best describes the ocular effects of Graves' disease?

1. Atrophy of the ocular muscles

2. Increased lacrimation

3. Inflammation and swelling of extraocular muscles

4. Loss of visual field

The correct answer is: Inflammation and swelling of extraocular muscles

Graves' disease, an autoimmune hyperthyroid condition, characteristically affects the eyes due to Graves' ophthalmopathy (also known as thyroid eye disease). This condition involves inflammation and swelling of the extraocular muscles. As a result, individuals often experience symptoms such as bulging eyes (exophthalmos), double vision, and restricted eye movement because the swollen muscles exert pressure on the ocular structures. The autoimmune process often leads to the infiltration of inflammation cells into the extraocular muscles, causing them to enlarge. This muscle swelling can disrupt normal eye function and lead to the visible ocular symptoms associated with the disease. While increased lacrimation could occur due to ocular irritation and other factors in thyroid eye disease, the primary and distinctive feature is the inflammatory process affecting the extraocular muscles. Atrophy of the ocular muscles and loss of visual field are not common features of Graves' ophthalmopathy; instead, the increased muscle mass due to inflammation prevails. Thus, the correct depiction of ocular effects in Graves' disease is inflammation and swelling of the extraocular muscles.