A 50-year-old man presents to his primary care provider complaining of double vision and trouble seeing out of his right eye. His vision started worsening about 2 months ago and has slowly gotten worse. It is now severely affecting his quality of life. His past medical history is significant for poorly controlled hypertension and hyperlipidemia. He takes amlodipine, atorvastatin, and a baby aspirin every day. He smokes 2–3 cigarettes a day and drinks a glass of wine with dinner every night. Today, his blood pressure is 145/85 mm Hg, the heart rate is 90/min, the respiratory rate is 14/min, and the temperature is 37.0°C (98.6°F). On physical exam, he appears pleasant and talkative. His heart has a regular rate and rhythm and his lungs are clear to auscultation bilaterally. Examination of the eyes reveals a dilated left pupil that is positioned inferolateral, with ptosis. An angiogram of the head and neck is performed and he is referred to a neurologist. The angiogram reveals a 1-cm berry aneurysm at the junction of the posterior communicating artery and the posterior cerebral artery that is impinging on and compressing the ocular nerve. Which of the following statements best describes the mechanism behind the oculomotor findings seen in this patient?
A. The parasympathetic nerve fibers of this patient’s eye are activated.
B. The unopposed superior oblique muscle rotates the eye downward.
C. The unopposed inferior oblique muscle rotates the eye downward.
D. The sympathetic nerve fibers of this patient’s eye are inhibited.
E. The unopposed medial rectus muscle rotates the eye in the lateral direction.