929-2 Fourth Nerve Palsy

Identifier: 929-2 Title: Fourth Nerve Palsy Subject: Hypertropia; Superior Oblique Paresis; Inferior Oblique Overaction; Fourth Nerve Palsy; Trochlear Nerve; Bielchowsky Test; Head Tilt; Description: The patient is a 64 year old engineer who noted whilst driving around Thanksgiving time double vision with one image on top of the other. Vertical double vision persisted and he was referred to the Massachusetts General Hospital for evaluation.