AC was a 21-year-old woman who lived in the Amana colonies in Iowa. She presented to the emergency room with the complaint of severe pain in her left eye starting the previous day. She stated that it was made worse on looking to the left and she also experienced double vision when she did this. Examination showed normal vision in both eyes with some swelling of the left eyelids with mild proptosis. The nasal conjunctiva showed moderate injection, especially over the insertion of the medial rectus muscle.
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