Abstract
Background: TAO is seen in about 80% of patients with Graves' disease; it may also occur in patients with thyroid cancers or autoimmune hypothyroid due to Hashimoto's thyroiditis in about 10% of TAO, while individuals with no thyroid disease were found to have orbital lesions in 10 percent of total cases. A 46-year- Case presentation: old male patient who is a known case of hypertension and hypothyroidism attended to medical OPD of SVS Hospital with foreign body sensation in both eyes, bulging of eyeballs and excessive watering in both eyes. He was on 40 mg of telmisartan and 50 micrograms of thyroxine daily for about 6 months. Pulse was 56 per minute and a blood pressure of 146/96 mmHg. The patient was treated with methyl prednisolone initially weekly intravenous doses followed by oral medication along with increased levothyroxine to 150 micrograms, selenium and statins. He was symptomatically better after 6 weeks of therapy. Summary and conclusion: Hypothyroid grave disease is very rare that too in a male patient. Treatment does not differ from Hyperthyroid Graves' disease except the supplementation of levothyroxine instead of anti-thyroid measures. The literature has been reviewed.
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