Abstract

We present to you a case of 38 years old male patient with moderate-severe thyroid eye disease ( fat predominant ) in a known case of hyperthyroidism since 6 years, status post thyroidectomy and status post 2 cycles of injection methyl prednisolone. Presenting to us with disfiguring axial proptosis since 1 year . Patient underwent a thorough clinical evaluation with computed tomography (CT SCAN) of orbit , pre operative photographs were documented and proptosis measured clinically and radiologically via CT. He was then planned for a 3 wall orbital decompression which was performed under general anesthesia, where first lateral wall decompression was performed using lateral canthotomy approach. Followed by medial wall decompression using trans-caruncular approach and finally orbital floor decompression using transconjunctival approach. Adjunctive orbital fat decompression was also performed.