This report outlines an unusual instance involving a 65-year-old man who has a medical history of beta thalassemia minor, diabetes mellitus complicated by retinopathy, and iron deficiency anemia. He presented with binocular diplopia, a condition that frequently presents treatment difficulties. Despite inconclusive magnetic resonance imaging (MRI) findings, the patient's symptoms improved significantly with prednisone treatment. The etiology likely includes underlying retinopathy and cranial nerve palsy associated with diabetic complications. This case highlights utilizing corticosteroids, a largely unexplored treatment option, to optimize outcomes in managing binocular diplopia potentially linked to diabetic etiologies. It is notable that this patient was treated in a clinic for uninsured patients, emphasizing his low socioeconomic background, which adds further layers of complexity to his medical care. The complexities of managing diplopia in diabetes, compounded by limited treatment efficacy and financial constraints hindering complete diagnostic evaluation, underscore the intricate challenges of addressing diverse binocular diplopia presentations.