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B-Scan ultrasonography was used to show muscle enlargement in all patients with Graves' disease and positive eye signs even when the clinical signs were minimal (lid lag and stare only). In addition, in cases of Graves' disease without clinical eye signs, 63% of orbital examinations showed ultrasonic evidence of muscle enlargement, often to a marked degree. This occurred more frequently in euthyroid patients after ablation of the thyroid by surgery or radiation, than in frankly thyrotoxic patients. The presence of subclinical ophthalmopathy in the fellow eye is a useful diagnostic aid in cases of uniocular proptosis.
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