Background: Thyroid ophthalmopathy is a rare extrathyroidal complication most commonly associated with Graves' disease. The disease course ranges from mild to severe, with severe cases resulting in major visual impairment and facial disfigurement.
Case: A 22-year-old primigravida developed severe thyroid ophthalmopathy during pregnancy, requiring high-dose steroids and surgical orbital wall decompression to restore visual acuity.
Conclusion: Severe thyroid ophthalmopathy can occur in the euthyroid pregnant patient. Corticosteroid therapy and surgical intervention may be required during pregnancy in this clinical scenario.