A 26 year old female presents with insidious onset of diplopia on alternate cover test, the patient has a right hypertropia, worse on right head tilt and left gaze. Which muscle is paralysed: (A) Left superior rectus, (B) Right superior oblique, (C) Right inferior rectus, (D) Left inferior oblique
Answer is B. Two important patterns:
Right (hyper) left (gaze) Right (tilt) - rt. so palsy.
Left (hyper) right (gaze) left (tilt) - lt. so palsy.