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All Journal Ophthalmologica Indonesiana
Safirah Khairuna
Department of Ophthalmology , Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada – Sardjito General Hospital, Yogyakarta
Health Professions Medicine & Pharmacology Public Health

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Concurrent Graves’ Ophthalmopathy and Sjögren’s Syndrome: A Case Report Banu Aji Dibyasakti; Nikolaus Erik Darmawan; Safirah Khairuna
Majalah Oftalmologi Indonesia Vol 52 No 2 (2026): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/oi.v52i2.102147

Abstract

Graves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease, while Sjögren’s syndrome (SS) is a systemic autoimmune disease characterized by exocrine gland dysfunction. Although both conditions share autoimmune mechanisms, their coexistence remains underrecognized. We report a case of a woman presenting with progressive bilateral proptosis, ocular discomfort, xerophthalmia, and xerostomia. Ophthalmologic examination revealed bilateral proptosis with preserved visual acuity and normal intraocular pressure. Thyroid function tests demonstrated suppressed thyroid-stimulating hormone (TSH) and elevated free thyroxine (FT4), while orbital imaging showed bilateral extraocular muscle enlargement and exophthalmos, supporting the diagnosis of Graves’ ophthalmopathy. In addition, severe dry eye symptoms, reduced Schirmer test values, and xerostomia raised suspicion of coexisting Sjögren’s syndrome overlap. The patient demonstrated gradual clinical improvement following multidisciplinary management and systemic therapy. This case highlights the diagnostic challenge posed by overlapping ocular manifestations, particularly dual-mechanism dry eye resulting from both exposure-related and aqueous-deficient mechanisms. Early recognition of autoimmune overlap conditions is essential to optimize diagnosis, multidisciplinary management, and long-term outcomes.
Co-Authors Banu Aji Dibyasakti Nikolaus Erik Darmawan