Thyroid Eye Disease

Power point of case presentation of 50 year old male with newly diagnosed hyperthyroidism who presents with ocular hypertension, acute onset proptosis and visual loss. Diagnosed with thyroid eye disease and compressive optic neuropathy. Treatment options discussed for visual loss in thyroid eye disease. The prognosis for ocular hypertension in thyroid eye disease and progression to glaucoma also discussed. Imaging: Number of Figures and legend for each: 16 Slide 4: Figure 1: Table of ocular findings in case Slide 5: Figure 2: Table of ocular findings in case, continued Slide 6: Figure 3: Montage of extraocular movements demonstrating limitation of motility, most pronounced in upgaze OU Slide 7: Figure 4: Evidence of lagophthalmos of the right eye Slide 8: Figure 5: Humphrey visual field at presentation showing generalized reduction of sensitivity OD and inferior arcuate defect (on right image); early inferior changes OS (on left image) Slide 9: Figure 6: OCT RNFL showing normal RNFL values OU with no loss Slide 10: Figure 7a (OD, left image), and 7b (OS, right image): Stereo disc photographs showing normal discs with no pallor, cupping or edema, only peripapillary atrophy OU Slide 12-16: Figure 8- 12: Serial coronal views of non-contrast CT orbits showing enlargement of inferior and medial recti OD > OS, also slight enlargement of superior rectus OD; crowding at orbital apex OD > OS Slide 17: Figure 13: Sagittal view of non-contrast CT orbit showing enlarged bellies of inferior and superior recti OD Slide 23: Figure 14: (Same as Figure 9) Coronal CT orbits without contrast showing enlarged extraocular muscles form thyroid eye disease Slide 31: Figure 15: Table of ocular findings from case comparing pre and post treatment Slide 32: Figure 16: Humphrey visual field OU after treatment showing improvement in inferior defects OU