No abstract

weeks with vomiting. During a remission at thirty-two weeks the fluoxetine was stopped but the sensation of a lump in the throat returned and it had to be restarted. Growth scans of the fetus showed the abdominal circumference to be on the 5th centile throughout the pregnancy. Labour was induced at thirty-seven weeks' gestation and a Ventouse delivery was required for fetal distress. She had a healthy girl weighing 2.7 kg. She was discharged on fluoxetine, with close surveillance from the perinatal mental health team; postnatal depression did not develop.

Orbital manifestations in Wegener's granulomatosis develop in over 50% of patients. Ischemic vasculitis and optic nerve compression result in visual impairment. This case report highlights the importance of the yellow lid sign in the diagnosis of orbital granulomatosis as well as provides an explanation for the reversal of this phenomenon.