Asymmetric proptosis as a presenting symptom of Hashimotos thyroiditis with hypothyroidism

Description

Thyroid ophthalmopathy is usually associated with Graves' disease; however, in 6.2% of patients with thyroid eye disease it can be associated with hypothyroidism.1 A 54-year-old woman from Tamil Nadu presented to our outpatient department with sudden onset of binocular diplopia for the past 5 months. She subsequently noticed that her right eye became more prominent than her left eye. She had no other focal deficits or features of raised intracranial pressure. Along with these ocular symptoms, the patient had fatigue and increased drowsiness over the past 5 months and had gained around 3 kg of weight over the same duration. She however did not complain of constipation, voice changes, pedal swelling, cold intolerance or facial puffiness. She had no features suggestive of hyperthyroidism in the form of tremors, increased sweating, palpitations, hyperdefecation or restlessness. She had no history of hyperthyroidism. She had no history of receiving treatment for hypothyroidism...

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