Spontaneous intercalated corneal epithelial folds in thyroid eye disease: a case report
Keywords:Asian continental ancestry group, Epithelium, corneal, Graves ophthalmopathy
We observed an under-recognized, ethnic-related sign in thyroid eye disease in a 41-year-old Chinese woman. Spontaneous corneal epithelial folds form after fluorescein staining as a result of tear film disruption related to orbital tension and upper lid pressure on the cornea. They occur in anatomically predisposed eyes similar to acquired lower lid epiblepharon. Like their chorioretinal counterparts, presence of corneal epithelial folds prompt for further workup, even in East Asian patients whose thyroid eye changes may appear less impressive.
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