A 31-year-old woman, 27 weeks pregnant with twins but otherwise without a remarkable medical history, presented to the emergency ward with a right-sided drooping eyelid that had appeared shortly after vomiting. She noted that she had never vomited with that much force. She initially noticed a dull pain behind the right eye, which faded within an hour. On neurological examination, a partial ptosis was observed without any other signs of cranial nerve dysfunction (Figure 1). Importantly, her pupils were equal and reactive, and her eye movement was unrestricted and painless. No headache or visual impairment was reported. Her vital signs were normal.