Paracentral corneal dellen: a rare sign of Graves ophthalmopathy

To report a rare sign, paracentral corneal dellen that developed in a middle-aged female patient with Graves ophthalmopathy.

A paracentral corneal dellen developed in the left eye in a 42-year-old woman who was diagnosed as Graves ophthalmopathy. The patient had remarkable upper eyelid retraction, upper eyelid lag and upward motility restriction. The Graves ophthalmopathy was classified as Grade IV according to NOSPECS classification.

Local artificial tear film and 0.3% Tobramycin eye drops were administered to both eyes. Twenty-four hours later, the left corneal dellen disappeared.

Graves ophthalmopathy can lead to paracentral corneal dellen because of severe upper eyelid retraction and upward motility restriction of the eye in spite of the lack of lagophthalmos. Artificial tear drop and antibiotic eye drop therapy helped even though the patient did not have corneal exposure.