Case Study 108 Noncongestive Graves’ Disease
CJ is a 53-year-old woman with a history of hyperthyroidism who noted prominence of her eyes over several months. She was referred to an endocrinologist who diagnosed Graves’ orbitopathy and referred her for echographic confirmation. This showed several thickened extraocular muscles bilaterally, which was consistent with her diagnosis. She was lost to follow-up for several years and then presented to her endocrinologist with the concern that her left eye was “bulging out more.” Exophthalmometry measurements were basically unchanged from the previous ones (OD 20 mm and OS 22 mm). An MRI scan showed borderline enlargement of several muscles, but no mass lesion was detected. An orbital surgeon was consulted and recommended orbital decompression.