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52 year old man with intermittent proptosis
Digital Journal of Ophthalmology 1998
Volume 4, Number 16
March 18, 1998
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Jeffrey T. Finer, M.D., Ph.D. | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Examination
Vital signs: Afebrile
Vision: 20/50 OD, 20/20 OS
Pupils: Normal OU
Motility: Moderate to severe limitation in all directions OD, worst on upgaze. Full OS.
Color: Normal OU
Exophthalmometry: 7 mm proptosis OD
External exam: See figure 1
Slit lamp examination: OD: There was 2+ conjunctival injection and a few SPK. The anterior chamber was deep and quiet. The iris and lens were normal. OS: Normal.
Applanation pressures: 16 mmHg OD, 12 mmHg OS.
Fundus examination: See figure 2
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Figure 1a
Figures 1a-1b. External exam showing the right eye is displaced inferiorly, injected, and with marked proptosis (7 mm). Also note that motility is decreased as seen here on left gaze.

Figure 1b

Figure 2a
Figure 2a-2b. Ophthalmoscopy (Left) Posterior pole OD, showing macular striae and choroidal folds. (Right) Nasal fundus OD, showing areas of elevation consistent with choroidal effusions. The fundus OS was normal.

Figure 2b