Reversal of No Light Perception in Dysthyroid Optic Neuropathy by Emergency Endoscopic Endonasal Orbital Decompression

Introduction: Thyroid dysfunction optic neuropathy (DON) is a severe complication of Graves’ ophthalmopathy. Orbital decompression surgery should be considered when conservative treatment fails. However, it is often contraindicated in patients who have lost light perception due to poor prognosis. Case summary: We present a case of a patient with DON who had lost light perception for several days and showed visual recovery after emergency endoscopic endonasal inferomedial orbital wall decompression. Discussion: Even in cases of total vision loss, endoscopic endonasal decompression of the inferomedial orbital wall may yield favorable outcomes in patients with DON. Clinicians should perform comprehensive assessments of disease status and prognosis to maximize the opportunity for visual recovery.