title: Thyroid Eye Disease With Significant Levator Involvement and Ptosis: A Case Report.
abstract: A case of an 87-year-old woman with a history of Graves disease presenting with a 5-year history of severe ptosis and very poor levator function of the left side is presented. MRI revealed marked enlargement of all extraocular muscles and significant enlargement of the left levator muscle. Given the patient's age and atypical presentation of thyroid eye disease (TED), she was taken to the operating room for biopsy and ptosis repair with frontalis suspension. Histopathological analysis revealed chronic inflammation and fibrosis consistent with Graves disease.
authors.affiliation: *Ophthalmic Plastic, Orbital and Reconstructive Surgery, Kresge Eye Institute, Wayne State University School of Medicine, Detroit; and †Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, U.S.A.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Scruggs
authors.forename: Evan H
authors.initials: EH
authors.lastname: Black
mesh_terms: D000369:Aged, 80 and over; D001706:Biopsy; D001763:Blepharoptosis / Q000175:diagnosis*; D005260:Female; D005355:Fibrosis; D049970:Graves Ophthalmopathy / Q000175:diagnosis*; D006801:Humans; D006984:Hypertrophy; D008279:Magnetic Resonance Imaging; D009801:Oculomotor Muscles / Q000473:pathology*; D013508:Ophthalmologic Surgical Procedures; D014792:Visual Acuity