FIG. 2.

Composite of selected clinical features in patients with TED. Patient photographs provided with their consent demonstrate (a) lagophthalmos (inability to close eyelid completely); (b) edema and hyperemia of the caruncle (white arrow) and plica (black arrow) (courtesy of P. Perros); (c) chemosis (conjunctival edema) (courtesy of P. Perros); (d) lateral flare due to upper eyelid retraction (courtesy of P. Perros); (e) exposure keratopathy (courtesy of P. Perros); (f) globe subluxation. This is a rare complication in which the eye is displaced anterior to the retracted eyelids. Trapping of the globe may result in painful keratopathy or vision loss. This patient is seen at time of urgent surgery to decompress the orbits and narrow the lid aperture (courtesy of P. Dolman); (g) superior limbic keratoconjunctivitis in eye associated with marked upper lid retraction. This chronic recurring condition is often associated with thyroid disorders and is characterized by enlarged vessels and subepithelial edema involving the superior bulbar conjunctiva and corneal limbus (courtesy of P. Dolman).