Thyroid orbitopathy in a young woman

Case presentation

A 36-year-old teacher presented who developed hyperthyroidism two years ago. She was treated with oral medication, which brought her symptoms under control. However, this relief was rudely disturbed three months ago when she developed swollen red eyes and eyelids. She was referred for ophthalmic evaluation at this stage.

Two weeks before her initial eye consultation, the patient noticed double vision while looking up at the surtitles at the opera. Her self-confidence was being eroded by the change in her facial appearance, and she felt that her job performance was suffering as a result. Her eyes were also dry and gritty, especially in the mornings.