A 55-year-old lady presented with swelling around both eyes with watering, double vision, and blurring of vision for 2 years with worsening symptoms for the last 3 months. She was a known case of bilateral thyroid eye disease with both eyes dysthyroid optic neuropathy. She had hyperthyroidism and was taking oral Carbimazole. Her recent reports show increased thyroid-stimulating hormone levels. There was a history of progressive loss of vision in both eyes for 6 months. The patient was a chain smoker and used to smoke 7–8 cigarettes per day for 50 years. She stopped smoking 6 months ago.