Case report describes unilateral proptosis in a euthyroid Graves patient, revealing diagnostic challenges and effective management with IV methylprednisolone.
Rationale: To report a case of Euthyroid Graves’ disease with Unilateral eye involvement and its diagnostic and management challenges. Patient Concerns: A 36-year-old female with left eye proptosis. Diagnoses: CECT and MRI reported the proptosis of the left eye with thickening of the left extraocular muscles without the involvement of the tendons, without a focal lesion, with mild hyperintensity and mild diffuse enhancement representing unilateral thyroid ophthalmopathy. Interventions: CECT and MRI for the diagnosis. IV methylprednisolone for the management. Outcomes: Complete resolution of symptoms by 6 months. Learnings: 1) Although commonly hyperthyroid, patients with Graves’ disease may be euthyroid. 2) Graves’ orbitopathy can affect the unilateral eye. 3) Long-term follow-up and joint endocrine and ophthalmology teamwork required for effective management.
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Rauniyar et al. (2026) studied this question.
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