title: Reactivation of thyroid associated orbitopathy following trauma with intraorbital foreign body.
abstract: A 63-year-old female with mild, bilateral, stable thyroid-associated orbitopathy sustained trauma resulting in glass foreign bodies embedded on the left ocular surface and left lateral orbital extraconal and intraconal space. After 2 orbitotomies including a failed attempt to remove the intraconal foreign body and poor response to oral steroids, she developed severe, progressive left periorbital edema and 9 mm of relative proptosis. Serial, post-operative imaging demonstrated worsening inflammatory changes along the surgical tract, which slowly improved over several months, with simultaneously worsening proptosis and enlargement of the left inferior and medial rectus muscles consistent with worsening thyroid orbitopathy. She subsequently underwent unilateral 3-wall orbital decompression with improvement in her symptoms. Periorbital trauma with orbital foreign bodies and related surgical trauma may result in reactivation of thyroid-associated orbitopathy.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , Massachusetts.
authors.forename: Thanos D
authors.initials: TD
authors.lastname: Papakostas
authors.forename: Nahyoung Grace
authors.initials: NG
authors.lastname: Lee
authors.forename: Alison B
authors.initials: AB
authors.lastname: Callahan
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Freitag
mesh_terms: D019299:Decompression, Surgical; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D005898:Glass; D049970:Graves Ophthalmopathy / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009915:Orbit / Q000293:injuries* / Q000601:surgery*
keywords: Reactivation; thyroid-associated orbitopathy; traum