Regression of thyrotoxic ophthalmopathy following lithium withdrawal

The case of a bipolar patient who developed thyrotoxicosis with severe exophthalmos while on lithium therapy is described. The patient had required two surgical decompressions of the right orbit to relieve pressure, which occurred secondary to progression of the exophthalmos, and was scheduled for further surgery. Lithium therapy was discontinued because of poor compliance to the medication and intolerable polyuria. The exophthalmos improved dramatically within 72 hours of the withdrawal of lithium. A severe form of exophthalmos resulting from lithium therapy has not been described in the literature. The case described here adds to the body of information about the possible causes of thyrotoxic ophthalmopathy.