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This 42-year-old woman was diagnosed with thyroid eye disease three years ago. She has undergone medical therapy and x-ray therapy. For the past two years she has been bothered with vertical diplopia. Visual acuity is 20/20 in each eye and her refraction is right eye +0.75 +0.5 axis 110 and in the left eye plano +0.75 axis 90. In the primary position she has approximately 20 prism diopters of right hypotropia with limitation of elevation of the right eye. The remainder of her eye examination is normal. She would like to be relieved of this double vision.

1.	Thyroid eye disease like this:
	a. usually resolves in 3 to 5 years b. as a first choice would be treated with prism c. is likely to get significantly worse d. is likely to remain stable as presenting here e. none of the above
2.	A logical course of treatment for this patient would include:
	a. patching of the left eye b. surgery on the left eye c. surgery on the right eye d. surgery on both eyes e. none of the above
3.	If surgery were done on this patient, it could be complicated by:
	a. a large myopic shift in the operated eye b. anterior segment ischemia c. lower lid ptosis d. poliosis e. difficulty with convergence

For answers to the above, click here on or after February 14, 2012.