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This 31-year-old man was involved in an altercation three days ago. He was struck in the right temple with a screw driver. He now complains of vertical diplopia that measures 12 prism diopters right hypotropia. Ductions show a slight limitation of elevation in the right eye. The remainder of the eye examination is normal. Vision is 20/20 (6/6) in each eye. The skin in the right temple area is reddened with a small scab.

1.	The double vision is:
	a. probably due to an old problem just now being noticed b. due to a weakness of the right inferior rectus c. is not likely to be due to the trauma d. probably related to the trauma e. none of the above
2.	The following could be the reason this man cannot look up normally with his right eye:
	a. weakness of the right superior rectus b. restriction to elevation in the right eye from swelling or hematoma c. trochlear restriction in the right eye d. blow out fracture e. all of the above
3.	What test would you want to do next?
	a. CT scan of the orbits b. Tensilon test c. exploration of the orbit d. none is needed e. none of the above

For answers to the above, click here on or after April 29, 2008.