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A 63 year-old woman with enophthalmos
Digital Journal of Ophthalmology 2005
Volume 11, Number 12
July 10, 2005
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Michelle Yao | University of Wisconsin
Mark Lucarelli, M.D. | University of Wisconsin
History
A 63-year old woman presented with enophthalmos and hypoglobus after orbital floor and medial wall transconjunctival decompression OS in 11/2000 for thyroid optic neuropathy. After the surgery, she underwent low dose orbital radiation. Her vision dramatically improved. The patient also underwent right orbital decompression for severe Graves orbitopathy in 02/2001.
The patient’s postoperative course after the left orbital decompression was peculiar in that she developed marked degree of enophthalmos and hypoglobus, OS, occurring subacutely post-operative. The Hertel exophthalmometry and hypoglobus measurements are presented below:



Preop: OD /OS
10/26/2000 25.5mm /25mm
Postop:
11/16/2000 23mm /20mm
12/06/2000 23mm /18mm
02/19/2000 22mm /18mm
03/22/2001 21mm /18mm 2-3mm hypoglobus OS
06/04/2001 19mm /14mm
04/15/2002 18mm /15mm 2mm hypoglobus OS
05/07/2003 18.5mm /15mm 3mm hypoglobus OS

Past Ocular history:
1. Severe Graves orbitopathy, OU; severe thyroid optic neuropathy, OS; mild thyroid optic neuropathy, OD.
2. Transconjunctival orbital floor and medial wall decompression with preservation of maxillo-ethmoidal strut, OS. 11/2/2000; s/p similar right orbital decompression on 2/13/2001.
3. Status post left medial rectus recession 4-5 mm and left inferior rectus recession 3.5 mm with Spielmann technique in 11/2001 for left esotropia and hypotropia.

Past medical History: Graves disease

Medications: none

Social History: materials clerk. Married, three children. 40-pack-year history of smoking

Family History: significant for autoimmune disease on father’s side. A paternal grandfather with a goiter, father with diabetes and a sister with alopecia.
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