title: A difficult diagnosis: severe Graves' ophthalmolopathy.
abstract: An 81-year-old woman with atrial fibrillation, on warfarin, with known hyperthyroidism, was admitted to hospital following a fall with proptosis and severely restricted movements in her left eye. Medics initially thought the presentation was related to an intracranial pathology but through subsequent tests and examination, ophthalmologists diagnosed a severe case of thyroid eye disease with intense inflammation. The patient responded well to systemic steroid treatment. This case report highlights a severe rapidly progressing case of thyroid eye disease with diagnostic difficulties arising from multiple comorbidities in an elderly patient.
authors.affiliation: Department of Ophthalmology, Heart of England NHS Trust, Birmingham, UK.
authors.forename: Ivan Yeu Ming
authors.initials: IY
authors.lastname: Yip
authors.affiliation: Heart of England NHS Trust, Birmingham, UK.
authors.forename: Fizza
authors.initials: F
authors.lastname: Mushtaq
authors.affiliation: Heart of England NHS Trust, Birmingham, UK.
authors.forename: Tristan
authors.initials: T
authors.lastname: Reuser
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D004359:Drug Therapy, Combination; D005094:Exophthalmos / Q000209:etiology; D005133:Eye Movements; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D049970:Graves Ophthalmopathy / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications; D008775:Methylprednisolone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone