On NBME exams, exophthalmos should always make you think of Graves disease (especially in the right demographic of a young or middle-aged woman)
Key idea: All causes of hyperthyroidism can lead to lid lag and lid retraction secondary to sympathetic activation of the superior tarsal muscle, but Graves specifically leads to exophthalmos and impaired extra-ocular motion due to glycosaminoglycan deposition behind the eyes
danielle359xJust to add something: while not pathognomonic for graves disease, sparing of the tendinous insertions is fairly specific for graves vs other inflammatory disorders.+3
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