Presentation
Known thyroid disease. Watery eyes. Blurred vision. Profound proptosis and chemosis.
Patient Data
Profound bilateral proptosis of 2 cm. The inferior eyelids are edematous. Congested pre-septal soft tissues.
Symmetrical bilateral superior, inferior, medial and lateral rectus muscle enlargement. The tendinous insertions are spared with marked enlargement of the muscle bodies.
The optic nerves has a slither of surrounding fat at the orbital apex due to surrounding muscle enlargement.
Case Discussion
This delayed presentation with thyroid eye disease demonstrates a profound example of the extra-ocular muscle enlargement typical of this condition.
The muscle bellies are enlarged with sparing of the tendinous insertions in the appearance of a traditional coca-cola bottle.
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