Hi, It seems to be a condition of 3rd nerve palsy, that means an oculomotor nerve palsy with double vision and droopy lid. The other possible cause is thyroid associated orbitopathy. The doctor needs to do a neurological exam and an eye muscle test to decide diagnosis. In the case of 3rd nerve palsy, evaluation depends on signs and symptoms, patient’s age and systemic diseases. Management depends on the current scenarios. In a conscious patient with ophthalmoplegia, droopy eyelid and wide pupil, a compressive etiology, as an intracraneal anurysm, must be ruled out. On the other hand, if a patient is having complete oculomotor nerve palsy without pupil involvement then it is most likely to be related to ischemic process, but compression and inflammation must be considered. The majority of complete or incomplete 3rd nerve palsy without pupil involvement are secondary ischemic process. Such patients see improvement after the first 4 weeks with full resolution in 12 weeks. Patients left with a residual disorder can opt for strabismus surgery after 6 months of stability to maximize the possibility of spontaneous resolution and surgical outcome. In these cases, the main goal of strabismus surgery is to provide alignment in primary and reading position. Best regards