A difficult diagnosis: severe Graves' ophthalmolopathy.

An 81-year-old woman with atrial fibrillation, on warfarin, with known hyperthyroidism, was admitted to hospital following a fall with proptosis and severely restricted movements in her left eye. Medics initially thought the presentation was related to an intracranial pathology but through subsequent tests and examination, ophthalmologists diagnosed a severe case of thyroid eye disease with intense inflammation. The patient responded well to systemic steroid treatment. This case report highlights a severe rapidly progressing case of thyroid eye disease with diagnostic difficulties arising from multiple comorbidities in an elderly patient.