A 59-Year-Old Man Comes to the Office Due to Diplopia

A 59-year-old man comes to the office due to diplopia and a drooping right eyelid.  His symptoms began a day earlier and have since worsened.  Physical examination shows a dilated right pupil that is nonreactive to both light and accommodation.  There is vertical and horizontal diplopia.  When the patient is asked to stare straight ahead, the right eye is directed inferiorly and laterally with respect to the left eye.  MRI of the brain reveals an aneurysm involving the right posterior communicating artery.  Which of the following muscles is most likely to remain functionally intact in this patient?

A) Inferior oblique
B) Inferior rectus
C) Lateral rectus
D) Levator palpebrae
E) Medial rectus
F) Superior rectus

Correct Answer:

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