A 44-year-old male presented with a gradual onset bilateral proptosis since 15 months. He was diagnosed as a case of Graves’ Orbitopathy before and treated with corticosteroids which showed minimal improvement. Three weeks prior to presenting, his proptosis worsened and he developed bilateral painless swelling of the face and temporal area along with eyelid edema and chemosis. He did not give any history of allergies or atopy, neoplasias, or other systemic diseases. Eye examination: Visual acuity- 20/40 in the right eye (OD) and 20/25 in the left eye (OS).
Hertel exophthalmometry- 30 mm OD and 28 mm OS. Right relatively afferent pupillary reflex and mild extraocular movement restriction in all gaze directions. No abnormalities detected over the slit lamp examination, intraocular pressure measurements, and fundoscopy. General examination: Bilateral palpable but not well-defined,…
