Thyroid associated opthalmopathy (TAO) may precede, coincide, or follow the systemic complications of dysthyroidism it can present gradually as dry eyes, puffy eyelids, ocular pressure or pain, field loss, diplopia with 3rd, 4th, 6th nerve palsies we report a 22 year old Filipina female who presented with sudden onset of diplopia, pain, headache, with no sign or symptom of dysthyroidism and clinically sounds to have 3rd, 4th, and 6th, nerve palsies (left eye) the case represents diagnostic dilemma that's why found it worth to be reported.