Prof.SARAVANA BHAVA BALACHANDRACHARI
A 37 year old male, presented to our OPD with history of squint in left eye since childhood, protrusion of both eyes, breathlessness and loss of weight since 1 year, loose stools for 6 months and difficulty in swallowing for 3 months. On systemic examination, BP- 140/90mmHg, pulse rate- 100/min, CVS- S1, S2+, CNS- tremors and diffuse Goitre. On ocular examination, both eyes UCVA-6/12 NIP, right eye showed exophthalmos and left eye had 450 exotropia. On Hertel’s exophthalmometry, right eye 20mm and left eye 17mm. Extra ocular movements showed restricted abduction, elevation, dextro and levo elevation in both eyes. On examination there was scleral show in both eyes, convergence insufficiency and right eye lid lag. Blood investigations showed elevated free T3 and T4 levels and low TSH. FNAC of Thyroid showed features of Benign Thyroid lesion. USG of neck showed grossly enlarged thyroid with increased vascularity. The patient is on T. Inderal, T. Neomercazole and T. Amlong.
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