Dysthyroid Orbitopathy (Kennerdell Case 5, PPT)

History: This is a 48 year old man referred with swelling and proptosis of the right eye with tearing and slightly blurred vision. His right upper and lower lids were puffy and the conjunctiva was slightly injected with 3mm proptosis of the right eye. Three months later, the patient demonstrated increased swelling of the upper and lower lids consistent with early thyroid orbitopathy of the left eye. Four months later, showed increased proptosis and swelling of the left eye with continued swelling of the right upper and lower lids. Five months later, showed the swelling of the upper and lower lids beginning to subside, but now, there was a vertical imbalance of the eyes with a marked hypertropia and limited upgaze, left eye. Six months later, with diminished swelling of the lids, marked increase in the asymmetry of the eye positions with a marked right hypertropia. Six months later, demonstration subsidence of the lid swelling, but with residual puffiness, fat prolapse, and skin redundancy. The vertical dissociation of the eyes has improved, but there was a persistent right hypertropia. Anatomy: Orbit. Diesease Diagnosis: Dysthyroid Orbitopathy; Thyroid Associated Opthalmopathy. Presenting Symptom: swelling and proptosis of the right eye with tearing and slightly blurred vision. Treatment: Refused treatment.