| These photographs may contain or show medical conditions in graphic nature. View these photographs responsibly. To contribute a case, contact Dr. Hom by email (click here) |
| Grand Rounds 69 |
| Case History: A 55 - year old woman presents for a routine eye examination because of presumed presbyopic symptoms. Questions: Before you even pick up the occluder or take acuities, what do you suspect? Response - See below the photos. |
 |
 |
| Response - 1. First ask the patient for any prior photos (such as family or ID or driver's license. 2. This is classic acquired acromegaly secondary to excessive growth hormone (GH) 3. Classifc acquired acromegaly involves swelling of the hand and joints 4. There is thickened, coarse, oily skin, 5. Enlargement of the lips 6. Deepening of the voice due to enlarged sinues and vocal cords 7. Excessive sweating. 8. Complications include diabetes, hypertension and cardivovascular disease 9. Acromegaly can also be caused by pancreatic, lung or adrenal tumors. 10. The most reliable method of diagnosing acromegaly is the IGTT.(impaired glucose tolerance test. |