Neuro-ophthalmology & Squint · NEET PG Preparation Ophthalmology
A 58-year-old patient develops sudden severe headache, diplopia, and left ptosis. Examination shows that the left eye is deviated down and out, and t…
Practice question from Neuro-ophthalmology & Squint (NEET PG Preparation Ophthalmology), with the correct answer and a step-by-step solution.
medium · MCQ · Q-A1D4E3
A 58-year-old patient develops sudden severe headache, diplopia, and left ptosis. Examination shows that the left eye is deviated down and out, and the left pupil is widely dilated and nonreactive. Which is the most likely cause?
- A.Diabetic microvascular third-nerve palsy
- B.Left optic neuritis
- C.Posterior communicating artery aneurysmCorrect answer
- D.Isolated sixth-nerve palsy
Solution
A painful, pupil-involving third-nerve palsy with ptosis and a down-and-out eye suggests compressive involvement of the oculomotor nerve. A posterior communicating artery aneurysm is a classic emergency cause. Microvascular palsies usually spare the pupil.
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