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Thyroid eye disease: an unusual presentation
  1. J Shankar1,
  2. C P Noonan2,
  3. P Mathew2,
  4. S Hanif2
  1. 1Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK
  2. 2Warrington General Hospital, Warrington, UK
  1. Correspondence to: Jai Shankar, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK; jai.shankar{at}tesco.net

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Viagra (Sildenafil) is an oral preparation for the treatment of male erectile dysfunction. Although the drug is marketed solely for its therapeutic purposes, it has high potential for abuse owing to its ability to intensify and prolong erectile response. We describe here an ocular side effect following its use as a recreational drug, which led to the diagnosis of thyroid eye disease.

Case report

A 30 year old white man was referred to the eye clinic, with a history of waking up one morning with a left proptosis, having had no ocular signs or symptoms the previous day. The patient did not have any subjective symptoms of pain, redness, change in visual acuity, double vision, or of hearing any sounds. There was no history of direct or indirect trauma. He …

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