An unusual presentation of dysthyroid orbitopathy
Reviewed by Claire Howard

The authors present a case of a 50-year-old male smoker who presented with bilateral gaze evoked amaurosis (GEA), i.e. the patient was aware of loss of vision in all gaze positions other than the primary position. The patient was being treated for thyrotoxicosis. A patient photo was interesting in that it did not show gross clinical signs of dysthyroid orbitopathy, however an MRI scan did show gross extraocular muscle enlargement. Clinical examination revealed optic disc swelling on both sides. The GEA was presumably caused by apical crowding exacerbated by extraocular movement. The patient’s symptoms were partially relieved with intravenous methylprednisolone and rituximab. 

Dysthyroid orbitopathy presenting with gaze-evoked amaurosis: case report and review of the literature.
Orlans HO, Bremner FD.
ORBIT
2015;34(6):324-6.