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A 57-year-old woman with a history of diabetes mellitus and hyperthyroidism presents to the emergency room with a history of 2 days of vertical and horizontal diplopia. There is moderate orbital pain. On examination the patient’s left eye is deviated downward and outward. It can be passively moved medially and upward. The pupils both react normally.

The patient most likely has a(n)?

a. Third nerve palsy

b. Fourth nerve palsy

c. Sixth nerve palsy

d. Orbital fracture

e. Graves’ disease

in Ophthalmology by

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a. Third nerve palsy