Presentation
Graves disease, worsening vision.
Patient Data
Age: 40 years
Gender: Female
Race: Asian
From the case:
Thyroid associated orbitopathy
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Bilateral proptosis and enlargement of multiple rectus muscles. Crowding, but not compression of the optic nerve, at the orbital apex.
From the case:
Thyroid associated orbitopathy
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Illustration of how the term 'coca cola bottle' sign arises. (Courtesy of Matt Skalski).
From the case:
Thyroid associated orbitopathy
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Marked enlargement of the inferior, medial and superior rectus muscles, with sparing of the tendinous insertions, giving a Coca-Cola bottle appearance.
Case Discussion
Bilateral proptosis due to thyroid associated orbitopathy. The enlargement of the muscles in this case follow the mnemonic I'M SLOW, which is typically the case.
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