A 65-year-old woman presented to the New England Eye Center with 4 weeks of decreased vision and 6 months of progressive ocular irritation, redness and retro-orbital pain in both eyes.
She noted an unusual prominence of her eyes but denied any double vision or pain with extraocular motility. Her medical history was notable for non-insulin-dependent diabetes, hypertension, hyperlipidemia, atrial fibrillation and a recent diagnosis of Graves’ disease, which was under good control. The patient was euthyroid and on a stable dose of methimazole. Her ophthalmic history was otherwise