Bilateral 4th nerve palsy 

A nice thing to check for is the chin down posture in bilateral 4th palsy. This posture compensates for the unopposed eye elevators as both superior obliques are affected. If it helps, I've created an animated video that explains this in detail.

Your lectures are awesome and so informative... GOD bless you 🙏🏻

thank you so much

It was good to see you today....you should do a video on my hot mess...