Instructions
You are a medical student on placement in the emergency department. Your next patient is Ayen Kuol, 56, an office manager, presenting with two days of a drooping left eyelid and double vision.
Examine the patient
Outline to the examiner:
- Your findings
- Your most likely diagnosis and differentials
- You do not need to take a further history
- Please verbalise your examination; findings will be provided on request
- The examiner will ask you questions at the end
History taken by the ED registrar
Lid half shut on waking, fully shut by evening. Double vision on lifting the lid, gone when either eye is covered. Dull ache behind the left eye since. No head injury. High blood pressure; no diabetes; smokes about 15 a day. No jaw pain on chewing, scalp tenderness or symptoms worse through the day.