Dysthyroid Orbitopathy, Optic Neuropathy and Esotropia (Kennerdell Case 60, PPT)

History: A 51-year-old woman referred with thyroid disease and consistent Dysthyroid Orbitopathy with optic neuropathy despite treatment with steroids, radiation and an inadequate anterior, medial and inferior decompression. Minimal proptosis, but continued compression of the Optic Nerves with visual loss. Anatomy: Orbit; Orbital disc; Entire medial rectus. Clinical: Hertel measurements were 21 in each eye with a base of 100. Disease Diagnosis: Thyroid Associated Ophthalmopathy; Dysthyroid Orbitopathy. Presenting Symptom: Consistent Dysthyroid Orbitopathy with optic neuropathy. Neuroimaging: An axial view of the patient following the medial inferior decompression. The axial view shows the extensive displacement of the enlarged medial recti into the former ethmoid air cell space. Treatment: Surgical decompression.