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A rare case of severe bilateral Graves’ orbitopathy involving an anophthalmic socket

Lookup NU author(s): Dr Anna Mitchell, Dr Catherine Napier, Professor Simon PearceORCiD

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Abstract

© 2023 The authors.This is a report of a rare case of Graves’ hyperthyroidism associated with severe bilateral Graves’ orbitopathy, in a patient with an anophthalmic eye socket. On clinical review her prosthetic eye (left eye) was tilting upwards, along with worsening of Graves’ orbitopathy (GO) in the only seeing eye. As she refused IV glucocorticoids, she was offered rituximab which only caused a transient improvement in the clinical activity score of the eye. She had persistent right upper lid retraction of 6 mm, associated with lagophthalmos. To protect her seeing eye from corneal ulceration, the patient received a botulinum toxin injection to the right upper eyelid to induce blepharoptosis as an interim measure prior to right upper eyelid blepharotomy in April 2021. This patient remains biochemically euthyroid on block and replace therapy and her TRAb level is falling over time. Treatment for active GO is ongoing and the patient required a redo blepharotomy for painful corneal exposure in the right eye.

Publication metadata

Author(s): Ali M, Abouzaid M, Clarke L, Lau G, Mitchell A, Napier C, Pearce S

Publication type: Article

Publication status: Published

Journal: Endocrinology, Diabetes and Metabolism Case Reports

Year: 2023

Volume: 2023

Issue: 1

Online publication date: 09/01/2023

Acceptance date: 19/12/2022

Date deposited: 06/02/2023

ISSN (electronic): 2052-0573

Publisher: BioScientifica Ltd.

URL: https://doi.org/10.1530/EDM-22-0341

DOI: 10.1530/EDM-22-0341

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