Open Journal of Ophthalmology, 2021, 11, 229-239 https://www.scirp.org/journal/ojoph ISSN Online: 2165-7416 ISSN Print: 2165-7408 DOI: 10.4236/ojoph.2021.113018 Aug. 9, 2021 229 Open Journal of Ophthalmology Unilateral Periorbital Oedema with Hypothyroidism and Multinodular Goiter Blerta Rama, Nishant Taneja, Nazmije Martinaj, Genc Shala, Admir Sulovari, Naser Gjonbalaj Department of Ophthalmology of Prishtina (Kosovo) and Tirana (Albania), Department of Internal Medicine and Rheumatology, Department Endocrinology, Radiology, Allergology, Infectiology, American Hospital Pristina, Prishtina, Kosovo Abstract Thyroid associated ophthalmopathy is an autoimmune disorder which involves orbital and periorbital tissue. The immune-mediated inflammation of the orbital tissues can involve extraocular muscles, orbital connective tissue or orbital fat and periocular soft tissues. Bilateral involvement of thyroid associated orbitopathy is usually asymmetric, but unilateral thyroid associated orbitopathy has been less reported. Periorbital oedema as the only sign with hypothyroidism is uncommon and if present, it is more frequent bilaterally present and no cases are evidenced as unilateral. Pitting oedema in hypothy- roidism is rare and can be due to increased capillary permeability, decreased adrenergic tone and increase in serotonin metabolism. Unilateral periorbital and eyelid oedema can associate with various clinical entities, multidiscipli- nary team is necessary to exclude the concomitant disease, so the patient can immediately be treated with proper therapy. We represent the case of un- usually unilateral recurrent periorbital oedema in the period of time for 3 years with stabilized primary hypothyroidism and multinodular goitre. Keywords Thyroid Associated Ophthalmopathy, Hypothyroidism, Periorbital Oedema 1. Introduction Thyroid associated ophthalmopathy is an autoimmune disorder which involves orbital and periorbital tissue, although the clear mechanism is not clearly un- derstood. Thyroid associated ophthalmopathy is the most common in Graves’ disease, but it also occurs in hypothyroid and euthyroid patients [1]. Thyroid associated ophthalmopathy (TAO) is associated in 80% of the cases with How to cite this paper: Rama, B., Taneja, N., Martinaj, N., Shala, G., Sulovari, A. and Gjonbalaj, N. (2021) Unilateral Periorbital Oedema with Hypothyroidism and Multi- nodular Goiter. Open Journal of Ophthal- mology, 11, 229-239. https://doi.org/10.4236/ojoph.2021.113018 Received: May 19, 2021 Accepted: August 6, 2021 Published: August 9, 2021 Copyright © 2021 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access