Chief & Presenting Author: Dr.Varnika Aditi Singh

Co Author(s): Dr.Tanu Singh, Dr.Navdeep Kaur

Abstract

52 year old male, k/c/o Grave's Disease presented with forward protrusion of both eyes for 6 months, decrease in vision and orbital pain for 1 month.BCVA (OU) was 6/12 with absence of RAPD, generalised restriction of extra ocular movements in all gazes, with fullness of eyelids. Anterior segment examination (OU) revealed conjunctival injection and chemosis, diffuse SPKs on cornea, NS1 grade cataract with elevated IOP in primary and upgaze. Exophthalmometry was (OD) 30 and (OS) 31 mm. Fundus examination showed grade 3 disc edema in both eyes. Derangement of color vision (CV) and contrast sensitivity (CS) was noted. CT orbit showed crowding of orbital apex and hypertrophy of all extra ocular muscles. Patient was diagnosed as Dysthyroid Optic Neuropathy with Clinical Activity Score of 6/7 and given high dose I/V MethylPrednisolone. After 2 weeks of treatment his BCVA improved to 6/6 with CS and CV returning to normal and gradual resolution of clinical signs and symptoms.