Dr. Shobhana Phukan, Dr. (Mrs) Bhanu Devi, Dr. Rajiv Kumar Das
A 14 year old girl presented with protrusion of both eyes for duration of 3 months and pain redness and watering of right eye for 20 days. On examination there was muscle wasting, weight loss and thyroid gland was enlarged. There was severe proptosis on right eye and moderate proptosis on left eye. On right eye conjunctiva was congested and a corneal lesion seen inferomedially with epithelial defect. On closing of lids there was exposure of 3mm on right eye and 1mm on left eye. Thyroid profile was suggestive of hyperthyroidism. CT orbit revealed picture suggestive of thyroid ophthalmopathy. It was diagnosed as a case of thyroid ophthalmopathy both eyes with exposure keratitis right eye. Medical management was done and lateral tarsorrhaphy was done for exposure keratitis. Thyroid ophthalmopathy is rare in children. Though mild lid signs are seen proptosis is rare. Thyroid ophthalmopathy with severe proptosis and exposure keratitis as seen in this patient is very rare in that age group