A 62-year-old woman presented to the office complaining of abnormal vision. The patient has been complaining of double vision for the last month. She has abnormality with walking downstairs, as she sees them duplicated. She used to read the newspaper every morning, but recently she can not read them due to the double vision exacerbated by reading. She has not had any recent trauma. She has a medical history of chronic hypertension and diabetes mellitus type 2. A lesion affecting which of the following structures would explain the patient's presentation?

Question

Quizplus · Accepted Answer

Eductional Objective: The ocular movements are innervated by the oculomotor nerve, the trochlear nerve, and the abducens nerve. The trochlear nerve provides the motor supply for the superior oblique muscle. Therefore, it mediates the internal rotation of the eye and depresses the eyeball while adducted. Trochlear nerve palsy could be either idiopathic or traumatic, and patients present with double vision that is exacerbated while looking down during reading or walking down the stairs.

A 62-Year-Old Woman Presented to the Office Complaining of Abnormal