“…So far, the top two modalities for managing diplopia are surgery for strabismus and botulinum toxin injections. [3,4] Hypokalemic paralysis is a very rare primary presentation of pSS. [1,2] Non-exocrine organ systems may also be involved, including the skin, lungs, gastrointestinal tract, central and peripheral nervous system, musculo-skeletal apparatus, and kidney.…”