Causes and risk factors
The cause of trochlear nerve palsy cannot be assessed in many cases. It could be congenital or acquired. Occasionally, it could be due to a head injury.
Clinical presentation
The patient with trochlear nerve palsy usually doesn’t develop many symptoms. However, he is likely to develop diplopia (double vision). The diplopia is worse on looking downwards. Most patients tend to develop a head tilt away from the affected side in order to reduce diplopia.
Investigations
A CT or MRI scan of the brain is usually necessary to diagnose this condition.
The doctor performs a head-tilt test in order to isolate trochlear nerve palsy. When the head is tilted to the side of the affected eye, the eye shows vertical deviation. This confirms trochlear nerve palsy.
Treatment
Treatment of trochlear nerve palsy involves treating the cause. Wearing prism glasses and performing eye exercises can help resolve the condition.
When to contact a doctor
Contact a doctor as soon as you experience any abnormal eye symptoms such as double vision.
Systems involved
Ophthalmic system, nervous system
Organs involved
Eye, nerves
