Image of the Week: Headache, retro-orbital pain, and diplopia

A 25-year-old man presents to the emergency department with headache, retro-orbital pain, and diplopia when gazing to the right. He had visited an urgent care clinic with right ear pain 2 weeks earlier and had received a short course of antibiotics. After some initial improvement, he became increasingly unwell before presenting today. Otoscopy reveals purulent discharge in the right ear ...