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Objectively Measuring Acquired Ocular Torsion Secondary to Trochlear Nerve Palsy with Zeiss Cirrus Optical Coherence Tomography.

Background: Optical coherence tomography (OCT) allows the identification of key fundus landmarks (fovea and center of optic disc) to help calculate estimated ocular torsion amounts in acquired ocular torsion disorders. A case of chronic trochlear nerve (CN IV) palsy secondary to stroke, in which obj...

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Published in:Optometry & Visual Performance Vol. 14; no. 2; pp. 125 - 128
Main Author: Borgman, Christopher J.
Format: case study pictorial Journal Article
Published: Optometric Extension Program Jun2026
Online Access:View this record in EBSCOhost
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      jtl: Optometry & Visual Performance
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      dt: Jun2026
      vid: 14
      iid: 2
      pid: 46881
      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Objectively Measuring Acquired Ocular Torsion Secondary to Trochlear Nerve Palsy with Zeiss Cirrus Optical Coherence Tomography.
      aug:
        au: Borgman, Christopher J.
        affil: Memphis, Tennessee Associate Professor, SCO BA, 2006, Central College, Pella, Iowa OD, 2010, Illinois College of Optometry, Chicago, Illinois
      sug:
        subj:
          Torsion Abnormality Diagnosis
          Tomography, Optical Coherence
          Trochlear Nerve Diseases Diagnosis
          Diplopia Etiology
          Diplopia Diagnosis
          Oculomotor Nerve Diseases Diagnosis
          Reproducibility of Results
          Female
          Aged
          Trochlear Nerve Pathology
          Trochlear Nerve Radiography
          Cranial Nerve Diseases
          Eye Movements
          Stroke Complications
          Retina Radiography
          Retina Anatomy and Histology
          Ocular Physiology
          Oculomotor Muscles Physiopathology
          Oculomotor Muscles Radiography
          Strabismus
          Aged: 65+ years
          Female
      ab: Background: Optical coherence tomography (OCT) allows the identification of key fundus landmarks (fovea and center of optic disc) to help calculate estimated ocular torsion amounts in acquired ocular torsion disorders. A case of chronic trochlear nerve (CN IV) palsy secondary to stroke, in which objective ocular torsion was measured with OCT software and basic trigonometric calculations, follows in this report. Case Report: A 68-year-old female patient with a history of brainstem stroke from five years earlier showed a right-eye hyper deviation of 2?. Resultant Parks-Bielschowsky three-step testing, as well as ocular torsion testing with OCT software measurements, helped determine that the patient's hyper deviation was secondary to a right CN IV palsy. Her objective ocular torsion was calculated using measurement tools and trigonometric functions derived from her OCT scans. Conclusions: OCT technology can provide objective methods for measuring ocular torsion in acquired ocular torsion disorders. Potential OCT software development and future study regarding the use of OCT in these ocular torsion disorders is needed.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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