case 3 - "I can't smoke anymore!"

So, I was lucky, because I had read this case before and when the specialist asked with a grin I answered. She replied "you can't even answer a simple question but this one you know?"

A 73 year old malay man, admitted with symptoms of an almost constant cough. He also complained of weakness in his right arm arm (actual word was "tangan saya lemah sampai nak merokok pun xboleh" - wth? haha). During examination, there are guttering of metacarpal of both hand. ptosis of right eyelid, Anisocoria(R-3mm L-4mm), pupil react to light.




note: this is not the actual pic, but it showws the condition

Name the condition of the pupil?
What is the diagnosis?


sigh, I pity the ones who read my blog