3rd January 2024

A 70-year-old South Asian male presents with a four-day history of horizontal diplopia

A 70-year-old South Asian male presents with a four-day history of horizontal diplopia. He presents with his daughter, as he has been having memory problems lately. Examination reveals that the diplopia disappears when the patient covers either eye, and the right eye does not abduct fully. Pupil examination is unremarkable, and there were no other ocular examination findings of note. They have a past medical history of hypertension and diabetes, for which they take 7.5mg ramipril and metformin 1000mg BD. A single BP reading today is 178/85 mmHg. Which of the following is most likely?

Select the SINGLE most appropriate option from the list below. Select ONE option only.