What ocular finding is most associated with Graves' disease?

Exophthalmos, or proptosis, is the ocular finding most commonly associated with Graves' disease, which is an autoimmune hyperthyroid condition. This phenomenon occurs due to the inflammation and swelling of the muscles and tissues surrounding the eye, a direct result of the autoimmune response that characterizes Graves' disease. The buildup of glycosaminoglycans (GAGs) in the retro-orbital space leads to increased volume, causing the eyes to protrude forward.

This finding is significant in clinical practice because it serves as a key indicator for diagnosing Graves' disease and assessing its severity. The presence of exophthalmos can also lead to complications, such as exposure keratopathy and diplopia, due to the restricted movement of extraocular muscles.

Other ocular conditions mentioned, such as astigmatism, cataract, and narrow-angle glaucoma, are not characteristically associated with Graves' disease. Astigmatism relates to the refractive error of the eye, cataracts are age-related lens opacities, and narrow-angle glaucoma is primarily a condition related to the drainage system of the eye, making them unrelated to the autoimmune processes of Graves' disease and its ocular manifestations.