Four Wall Orbital Decompression for Proptosis (Kennerdell Case 59, PPT)

History: Patient with thyroid disease developed a chronic aggressive proptosis over a one year period. Hertel measurements were 30 in both eyes with a base of 102. Anatomy: Orbit; Ethmoid bone. Clinical: Hertel measurements were 30 in both eyes with a base of 102. Disease Diagnosis: Thyroid Associated Ophthalmopathy; Dysthyroid Orbitopathy. Presenting Symptom: Chronic aggressive proptosis. Neuroimaging: An axial CT scan demonstrating the marked proptosis. The patient without extraocular muscle enlargement, but with increase in the fat content of the orbit causing the proptosis. Coronal view of the orbit showing the increase in fat content. Treatment: Four wall orbital decompression.