Dr. Swetha. S, Dr. Megha
A 35 year male patient presented with history of prominence of both eyeballs R>L since 8 months. He had restriction of movements of the eyeball.He gives history of weight loss, palpitations and tremors. He was recently diagnosed Diabetes and hyperthyroidism.Tthere was lid retraction, severe exposure keratopathy in Right eye. Left eye showed lid retraction, exposure keratopathy and vascularisation of peripheral cornea and cataractous lens. He had no Perception of light in right eye and 6/36 in left eye.
Both eyes showed Axial proptosis. Proptometry readings were 40mm and 35 mm of right and left eyes respectively. He was advised Thyroid profile, CT and MRI- Brain& Orbit.
Results: TSH- 0.005 microunits/ml, T3- 651ng/ml, T4- 24.86 ng/ml. CT & MRI Orbit showed- Hypertrophy of B/L extraocular muscles involving predominantly their bellies(R>L)–Possible Thyroid Orbitopathy. Endonasal Medial wall orbitotomy was performed to left eye under LA to prevent compressive optic neuropathy.