Acute presentation of thyroid ophthalmopathy.

Three patients are described who presented with acute painful proptosis, ptosis and ophthalmoplegia. Orbital cellulitis was initially diagnosed in all cases, but there was no therapeutic response to antibiotics. A dramatic improvement occurred with steroids. All patients had, or developed abnormal thyroid tests and CT Scans showed thickened ocular muscles. This is an unusual presentation of thyroid ophthalmopathy.