Final answer:
The patient in the question is a 55-year-old with DM and HTN who develops R periorbital pain and diplopia. Examination reveals paralysis of abduction of the R eye. This presentation is consistent with abducens nerve palsy, most likely caused by microvascular ischemic infarction.
Step-by-step explanation:
The subject of this question is Medicine.
The grade of this question is College.
The patient in the question is a 55-year-old with diabetes mellitus (DM) and hypertension (HTN) who develops right periorbital pain and diplopia. The examination reveals paralysis of abduction of the right eye.
This presentation is consistent with a condition called abducens nerve palsy. The abducens nerve (cranial nerve VI) controls the lateral rectus muscle, which is responsible for the abduction (outward movement) of the eye. In this case, the paralysis of the right eye's abduction indicates damage to the right abducens nerve.
The most likely cause of abducens nerve palsy in this patient with DM and HTN is microvascular ischemic infarction. Diabetic and hypertensive patients are at increased risk of developing microvascular disease, which can affect the small blood vessels that supply the nerves.