DR. MAHESHWARI VANGURI

DR. MODINI PANDHARPURAR

Abstract

A 45/M patient presented with complaints of forward displacement of LE since 10 years associated with diminition of vision in LE.He is a known case of Mitochondrial myopathy, Hypertension and Hypothyroidism since 10 years on regular medication.BCVA-RE:6/9,LE:counting fingers,ocular symmetry lost due to LE proptosis,HCRT RE:central,LE:15 hypodeviation,palpebral fissure height-RE:11 mm,LE:13 mm,marginal reflex distance-RE:4mm,LE:6mm,lagophthalmos of 1mm in LE.Hertels exophthalmometry with 102 base reading-RE:18mm,LE:23mm.Elevation and abduction limitation in LE.Clinical activity scoring –RE:0/7,LE:3/7.Anterior segment examination showed RE–normal with nuclear sclerosis,LE- Upper lid retraction(1-2mm),inferior scleral show with nuclear sclerosis.RE fundus-normal,LE-High myopic fundus with posterior staphyloma.

CT orbit suggestive of Thyroid associated orbitopathy.

CONCLUSION–As CAS scoring is 3/7 in LE, we have educated the patient about his condition and asked to follow up regularly.