Acquired diplopia. Not always a neurologic problem

A case is presented in which a 49-year-old man has had progressive proptosis and diplopia over a six-week period without pain, loss of vision, or history of other ophthalmic or systemic disorders. The diagnostic work-up leading to a diagnosis of thyroid ophthalmopathy in such cases is discussed. Although the orbitopathy usually has a self-limited course, major complications are corneal exposure and optic neuropathy. The several modes of therapy available to treat these complications (systemic corticosteroids, orbital radiation, and orbital decompression are described.