Thyroid orbitopathy with subconjunctival fat prolapse

Case contributed by Dr Heba Abdelmonem


Right proptosis.

Patient Data

Age: 65-70 years
Gender: Male

Bilateral proptosis more on the right side. Abnormal bilateral diffuse enlargement of the EOMS sparing the tendon insertion with the following distribution (Inferior rectus, medial rectus, superior rectus, lateral rectus and superior oblique on the right side) being more severe on the right side.
Abnormally increased deposition of the retro-ocular orbital fat associated with herniated fat at the superior aspect of the bilateral epibulbar areas with the prolapsed fat in continuity with the intraconal fat lying between the lateral wall of the globe medially and the lateral rectus muscle laterally. Opacified examined part of the para nasal sinuses.

Case Discussion

Diffuse enlargement of the extraocular muscles in the distribution of I'M SLOW (mnemonic) that fits the thyroid orbitopathy. The increased deposition of the intra-orbital fat results in subconjunctival fat prolapse on both sides.

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Case information

rID: 66595
Published: 26th Feb 2019
Last edited: 2nd Mar 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Zagazig University Hospital

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