Thyroid eye disease

Case contributed by Ian Bickle


Suspected thyroid eye disease, worsening symptoms, sight threatening, retro-orbital pain, worse on left side,

Patient Data

Age: 40 years
Gender: Male

Bilateral proptosis, right more than left.

Bilateral intraocular muscle enlargement, in particular the medial, inferior and superior rectus muscles. The muscular enlargement is marginally more pronounced on the left. The signal characteristics indicate muscular edema.  The muscular enlargement spares the tendinous insertions in keeping with a coca cola bottle appearance.

The optic nerves on both sides remain surrounded by ocular adipose tissue including at the orbital apex.

Case Discussion

A typical example of thyroid orbitopathy with coca cola appearance to the intraorbital musculature.

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