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2004 Series -  June 22, 2004 Lecture 28 of 50  NEXT»

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This 42-year-old man is in good health and denies any significant head trauma.  He has noted intermittent diplopia for four years.  It becomes worse when he is tired and is relieved some by tilting his head.  The right hypertropia (left hypotropia) measures 25 prism diopters at the maximum. 

 

 

1.  The most likely diagnosis is: 
 

a.  left superior oblique palsy
b.  right superior oblique palsy
c.  r
ight inferior rectus palsy
d.  left inferior rectus palsy

2.  The most likely etiology is: 
  a.  congenital
b.  acquired from occult trauma
c.  systemic neurologic disease

d.  none of the above

3.  A logical treatment plan could include:
  a.  surgery on two extraocular muscles
b.  weakening of one oblique and one rectus muscle
c.  superior oblique traction testing at the time of surgery
d.  all of the above


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