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A 60-year-old man presents to the emergency department with painless, atraumatic diplopia. He has no known past medical history and has never been to the doctor. The left eye is deviated inferiorly and laterally during forward gaze. His pupillary exam is normal, and he has no extremity weakness.

Which of the following is most likely to determine the etiology of his findings?

A. CT angiogram
B. Orbital CT
C. Serum glucose
D. Tonometry

Answer :

Final answer:

The most likely etiology of the findings is a growth of the pituitary gland pressing against the optic chiasm, causing diplopia and deviated eye movement.

Explanation:

The most likely etiology of the patient's findings is a growth of the pituitary gland pressing against the optic chiasm, causing the deviated eye and diplopia (double vision). The optic chiasm is where the optic nerves from both sides meet and fibers sort so that the two halves of the visual field are processed by opposite sides of the brain. In this case, the growth of the pituitary gland interferes with the transmission of signals, resulting in the loss of lateral peripheral vision in the affected eye.

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