A 73-year-old man with congestion and mild proptosis of the left eye

Abstract

A 73-year-old man presented to the Department of Ophthalmology, Amala Institute of Medical Sciences, Kerala, with mild congestion of left eye. He believed that his symptoms began after accidental exposure of his eyes to medicated oil used during a massage session, as part of traditional medical treatment he was taking. He was diagnosed with toxic conjunctivitis and treated with loteprednol eyedrops. At his follow-up visit on the third day, he complained that his left eye had not improved and that it was starting to “bulge out.” The patient denied vision loss, double vision, headache, or other systemic symptoms. He had undergone bilateral orchidectomy and radiotherapy for prostate carcinoma 3 years earlier and was now on hormone therapy with bicalutamide. He had undergone thyroidectomy for hyperthyroidism 15 years previously and was now on levothyroxine. Ocular history was remarkable for uneventful cataract extraction in both eyes with IOL placement 20 years previously.