This patient presented acutely with the above ocular signs.

a. What is the diagnosis? 

b. What is the most important physical sign you would like to look for?

a
Answer a
Right partial third nerve palsy.
 

Answer b
Dilatation of the right pupil. A dilated pupil in the presence of third nerve 
palsy suggests a surgical third nerve as may be caused by an intracerebral 
aneurysm (typically in the posterior communicating cerebral artery). Because 
of the risk of subarachnoid haemorrhage, it should be treated as an emergency.