A rare case report on thyroid associated orbitopathy

Abstract

Thyroid associated orbitopathy (TAO) or graves disease is an autoimmune disorder associated with hyperthyroidism though few cases of hypothyroidism and euthyroidism are also found. Most common presentation is eyelid retraction followed by exophthalmos. Although TAO is more common in women, the proportion in men increases as severity increases. We report a case of young adult woman who presented with proptosis, severe ptosis in right eye and motility restriction in both eye with moderately painful swelling of right eyelid. CEMRI orbit revealed swelling of bilateral recti muscles with sparing of tendons which is characteristic of TAO. Thyroid profile showed hyperthyroid state, Clinical features were suggestive of orbital apex syndrome and diagnosis of TAO was based on orbital muscle changes in MRI. A course of methylprednisolone was given with tapering dose which improved proptosis, ptosis and extraocular movement on follow up.