In this case report, we present the rare occurrence of supernumerary extraocular muscles (SEOM) in a 35-year-old male with hyperthyroidism. SEOMs are unusual anatomical variations involving extraocular muscles that deviate from the typical muscle arrangement in the eye. While SEOMs are rare, they can have diverse clinical manifestations, including restrictive strabismus and lid abnormalities. In this case, the patient displayed right-sided lid retraction and an asymmetrical palpebral aperture, which raised concerns about a potential association with thyroid eye disease. However, imaging revealed that the SEOM was anatomically connected to the superior rectus muscle, possibly contributing to the observed lid retraction. Understanding the complexities of SEOM and its potential interactions with conditions like thyroid ophthalmopathy is crucial for accurate diagnosis and management. Further research is needed to fully comprehend the development and clinical impact of SEOMs due to their rarity and limited knowledge in the medical literature.
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