Diplopia in superior oblique palsy – Ophthalmology MCQ

Diplopia in superior oblique palsy is?

A. Vertical diplopia on downward gaze
B. Vertical diplopia on upward gaze
C. Horizontal diplopia on inward gaze
D. Horizontal diplopia on outward gaze

Correct answer : A. Vertical diplopia on downward gaze
Diplopia in superior oblique palsy

In paralysis of the superior oblique muscle (trochlear nerve palsy), maximum diplopia is experienced when the patient looks down.
This is especially important when the patient tries to climb downstairs and when trying to read a book.
The patient tries to compensate by tucking the chin towards the chest.