Graves ophthalmopathy and orbitotomy

Case contributed by Dr Shervin Sharifkashani

Presentation

A history of bilateral proptosis due to Graves disease with decompression orbitotomy.

Patient Data

Age: 60 years
Gender: Male

Pronounced enlargement of all extraocular muscles more prominent rectus muscles on both sides, bilateral proptosis, orbital medial wall, and floor orbitotomy, apical crowding and decreased optic nerve sheath complex width in proximal to middle segments due to the compressive effect of enlarged extraocular muscles are seen. Esodeviation of both eyes and intraocular lens implant in the left eye is also noted. Bulge of the enlarged muscles within orbitotomy defects in both side orbital cavities medial wall and floor is seen.

Case Discussion

The case illustrates typically enlarged extraocular muscles in Graves disease and decompressive orbitotomy as a major treatment of crowding of the enlarged muscles in the apex of the orbit

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