In Park's 3-Step test for a left CN IV palsy, which is the first step?

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Multiple Choice

In Park's 3-Step test for a left CN IV palsy, which is the first step?

Explanation:
Park's three-step test starts by identifying which eye is higher when looking straight ahead. This first step establishes the baseline vertical misalignment before you test gaze direction and head tilt. In a left superior oblique palsy, the left eye sits higher in primary gaze, so you see left hypertropia with the patient looking straight ahead. This occurs because the left superior oblique, which normally helps depress and intort the left eye, is weak, allowing the eye to drift upward relative to the right. Establishing which eye is hypertropic in primary gaze is the essential starting point, guiding the subsequent steps to localize the paretic muscle.

Park's three-step test starts by identifying which eye is higher when looking straight ahead. This first step establishes the baseline vertical misalignment before you test gaze direction and head tilt.

In a left superior oblique palsy, the left eye sits higher in primary gaze, so you see left hypertropia with the patient looking straight ahead. This occurs because the left superior oblique, which normally helps depress and intort the left eye, is weak, allowing the eye to drift upward relative to the right. Establishing which eye is hypertropic in primary gaze is the essential starting point, guiding the subsequent steps to localize the paretic muscle.

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