A 72-year-old man presented in October 2008 complaining of a yellowish bulge protruding under the upper eyelid of both eyes for the past 6 months and a gradually worsening “swelling” of his eyes. Clinical and paraclinical testing revealed hyperthyroidism and signs of Graves orbitopathy. An orbit MRI revealed excess orbital fat herniating anteriorly (). The lacrimal gland on either side was identified in place and was of normal size. He was followed for 15 months, during that time thyroid levels stabilized, without an improvement in the size of the lesion.
A 65-year-old woman presented in October 2010 for evaluation of a melanocytic lesion on her right upper eyelid. She reported a long history of hypothyroidism and bilateral exophthalmos, upon remission at the time of presentation. Asymmetric bilateral subconjunctival temporal protrusions were noted () which by history had emerged shortly after the onset of TAO. There was no change in the clinical picture after 5 months’ follow-up time.