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The patient's appearance on admission to Endocrinology research centre (Moscow, Russia).. Notes: OU (both eyes): exophthalmos; OS (left eye): interpalpebral adhesion, lagophthalmos, hypotropia, and corneal ulcer.
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Partial ankyloblepharon (result of tarsorrhaphy), lagophathalmos, hypotropia, and corneal ulcer were revealed (Figure 1).
Multislice CT scan (coronal plane) prior to orbital decompression.. Note: There is significant enlargement of the extraocular muscles, more pronounced on the left, and apical crowding.
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Multislice CT scan of the orbits revealed marked enlargement of extraocular muscles, apical crowding, swelling and fibrous changes in the orbital fat, and tightening optic nerves (Figure 2).
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Multislice scan (coronal plane) 1 week after bony decompression of the left orbit.. Notes: There are defects in the lateral, medial, and inferior orbital walls. Significantly enlarged medial and inferior rectus muscles are displaced toward the defects in the corresponding walls. The lateral rectus muscle and orbital fat are observed outside the internal contour of the lateral wall.
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The findings of the multislice CT scan after the surgery are shown in Figure 3.
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The patient's appearance 3 months after the orbital decompression and 1 month after the radiation therapy.. Notes: OS (left eye): hypotropia, upper eyelid retraction, lagophthalmos, and superficial keratopathy.
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Eight months after the end of radiation therapy, the patient underwent a surgical procedure for OS strabismus correction at a local clinic (Figure 4).
The patient's appearance 16 months after bony orbital decompression and strabismus surgery. Orthotropy in primary gaze position.
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Normalization of the eye position allowed to cut interpalpebral adhesion without a risk of a corneal ulcer recurrence (Figure 5).
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