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This 38-year-old woman was involved in an automobile accident 18 months ago.  Since that time she has had intermittent double vision but can see one image in the primary position and most of the time while reading.  Her vision is 20/20 in both eyes unaided and her eye examination, except for what is seen in the pictures, is normal.

1.	The most likely diagnosis is:
	a. traumatic Brown syndrome of the left eye b. fourth nerve palsy of the left eye c. inhibitional palsy of the contralateral antagonist d.  partial third nerve palsy e. none of the above
2.	An event in the recovery process from the original injury is demonstrated by:
	a. the elevation of the left upper lid on down gaze b. the head posture c. apparently straight eyes in the primary position d.  the position of the right lower lid e. none of the above
3.	Treatment in this case should be:
	a. exploration of the left superior oblique and trochlear area to free restrictions b. orthoptic exercises c. nothing, just observation d.  segmental vertical prism base up in the left lens e. none of the above

For answers to the above, click here on or after April 10, 2007.