Cranial nerves: fourth nerve palsy: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Cranial nerves: fourth nerve palsy

Sample item

A patient with right superior oblique palsy has vertical diplopia. To compensate, which head posture is adopted?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Tilt to the left shoulder

The head tilts away from the paretic side to avoid intorsion by the overacting inferior oblique and to reduce diplopia. The Bielschowsky head tilt test is positive when tilting toward the affected side increases the hypertropia.

Option by option

  • A. Tilt to the left shoulder (correct)

    Correct. The head tilts to the opposite shoulder.

  • B. Turn to the right with no tilt

    A face turn alone does not compensate for a vertical deviation.

  • C. Chin elevation only

    Chin elevation is not the typical posture.

  • D. Tilt to the right shoulder

    Tilting to the same side worsens the double vision.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Tilt to the left shoulder. The head tilts away from the paretic side to avoid intorsion by the overacting inferior oblique and to reduce diplopia.

Why is "Turn to the right with no tilt" not the answer?

A face turn alone does not compensate for a vertical deviation.

Why is "Chin elevation only" not the answer?

Chin elevation is not the typical posture.

Why is "Tilt to the right shoulder" not the answer?

Tilting to the same side worsens the double vision.

What concept does this question test?

It tests Cranial nerves: fourth nerve palsy in Ophthalmology. The Bielschowsky head tilt test is positive when tilting toward the affected side increases the hypertropia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cranial nerves: fourth nerve palsy?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.