Case 2

Like the patient in case 1. This patient can be easily mistaken for thyroid eye disease involving the right eye because of the apparent right upper lid retraction. However, she has no proptosis or thyroid eye disease.  She has right hypertropia and previous superior rectus muscle surgery resulting in right upper lid retraction. A cover test brings the right eye into the primary position and significantly reduces the retraction.   Right upper lid retraction. Reduced retraction with cover test.   a Return to clinical examination