Figure 1.

(A) Patient’s photography (taken with the patient’s cellphone) in April 2021 before BNT162b2 mRNA COVID-19 vaccine indicating no obvious sign of clinical thyroid eye disease. (B) Patient’s photograph 3 weeks after the second dose of the vaccine indicating exophthalmos, eyelid swelling and upper eyelid retraction. (C) Clinical photograph of the patient at presentation in March 2022, demonstrating bilateral exophthalmos, chemosis, conjunctival injection, upper eyelid retraction, swollen eyelids and caruncles. (D) Patient’s photography after third dose of IV methylprednisolone indicating marked improvement of the eye signs with no eyelid and caruncles swelling and chemosis, albeit with mild conjunctival injection.