Torsional diplopia may frequently accompany Graves' orbitopathy and is often not recognized. Some patients with manifest cyclotorsion do not complain of torsional diplopia because it is concealed by the large vertical and/or horizontal deviation. Torsional diplopia can occur spontaneously or appear after decompression or strabismus surgery. We discuss some interesting points arising from three cases. This will be followed by a discussion of the literature on the pathogenesis of cyclodeviation in Graves' orbitopathy.
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