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OD

OS

A 30-year-old male suffered head trauma in a motor vehicle accident resulting in the loss of consciousness.  Upon awakening he complained of double vision with the images tilted.  With his chin down and looking up he could avoid the double vision.  The remainder of the eye examination was unremarkable until the retina was examined.

1.	The most remarkable feature of the retina examination is:
	a. tortuosity of the vessels b. lack of a cilioretinal vessel c. hyperpigmentation of the macula d.  extorsion of the globe e. none of the above
2.	Which way would the images be tilted?
	a. extorsion, both eyes b. extorsion OS, intorsion OD c. intorsion, both eyes d.  intorsion of the left eye and extorsion of the right eye e. It is impossible to tell from these images.
3.	What is the most likely diagnosis in this case?
	a. dissociated torsional deviation b. bilateral superior oblique palsy c. pulley heterotopia d.  Heiman-Bielschowsky response e. none of the above

For answers to the above, click here on or after February 12, 2008.