ISSN 2757-8135 | E-ISSN 2757-9816
End stage thyroid ophthalmopathy presenting with bilateral exposure keratitis [Eur Eye Res]
Eur Eye Res. Ahead of Print: EER-79188 | DOI: 10.14744/eer.2022.79188

End stage thyroid ophthalmopathy presenting with bilateral exposure keratitis

Betul Akbulut Yagci, Canan Aslı Utine, Aylin Yaman
Department of Ophthalmology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey

The present case reports a 70-year-old female patient who presented with bilateral exophthalmos, lagophthalmus, and ex-posure keratitis. An aggressive topical treatment was commenced that included fortified vancomycin and ceftazidime. She was subsequently diagnosed with severe thyroid ophthalmopathy (TO) due to severe static and dynamic tremor that raised suspicion and abnormal thyroid function tests indicating Graves’ Disease. She was diagnosed with bilateral exposure keratitis secondary to TO in which the clinical activity score was assessed as 5. As her TO was sight-threatening, she was administered intravenous pulse methylprednisolone, followed by bilateral balanced 2-wall (medial and lateral) decompression and lateral temporary tarsorrhaphy surgeries. As her exophthalmos and lagophthalmos improved postoperatively, both eyes’ keratitis significantly regressed, and left scar tissue in the cornea. This extreme case should raise awareness for clinicians in the eti-ological investigation of exposure keratopathy to identify sight-threatening thyroid ophthalmopathy and promptly initiate appropriate treatment.

Keywords: Exposure keratitis, thyroid ophthalmopathy, thyroid orbitopathy.

Corresponding Author: Canan Aslı Utine, Türkiye
Manuscript Language: English