Lucas Maischner | Kings College Hospital Kashif Qureshi | St George's Hospital Fiona Robinson | Kings College Hospital Scott Robiee | St George's Hospital Shahram Kashani | Kings College Hospital Neelanjana Dutt | Kings College Hospital
Examination revealed a collapsed nasal bridge and swollen left upper eyelid (figures 1and 2). Cover testing in primary position demonstrated left hyportropia with increased height in lateral gaze together with chin elevation .
Extra ocular movements revealed limitation of upgaze in the left eye with vertical diplopia. He had 3mm axial proptosis and there was marked conjunctival injection on the lateral aspect of the left eye .
His visual acuities, colour vision, pupillary reflexes, and fundoscopy were normal .