Immunoglobulin G4 Related Ophthalmic Disease Presenting as Diplopia and Headache

Immunoglobulin G4 (IgG4)-related disease is a recently recognized entity characterized by abundant tissue infiltration by IgG4-positive plasma cells and high serum levels of IgG4. IgG4 disease can also affect the lacrimal glands and periocular tissues and usually manifest painless eyelid or periocular tissue swelling. However, IgG4 related ophthalmic disease rarely cause diplopia. We report a case of diplopia IgG4 related ophthalmic disease presenting as diplopia and headache.