Proptosis a borderline between medical and surgical practice: Dysthyroid ophthalmopathy for example

The association hyperthyroidism–exophtalmia is pathognomonic of the Graves disease. Classically, the treatment is based on a pluridisciplinary approach with a precise chronology. Surgical management of dysthyroid orbitopathy is not based on consensus. When confronted with such particular situations; it can be proposed to treat surgically at the same time the endocrine disease and the ophthalmologic complications. The authors report the case of a 67 -year-old man suffering from Graves’ disease with severe bilateral exophthalmia, treated by orbital decompression with a good result after ten months. This non-conventional approach highlighted by the authors can be useful in particular situations when the medical environment is not optimal. It helps prevent ocular complications caused by Graves' disease and improves the prognosis of patients with low capacities for the survey. •The association hyperthyroidism–exophtalmia is pathognomonic of the Graves disease.•The management of proptosis is on the borderline between medical and surgical practice.•Surgical management of dysthyroid orbitopathy is not based on consensus.•It can be proposed to treat surgically at the same time the endocrine disease and the ophthalmologic complications.