Step I diplopia

[MudPhud20XX]

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I had a UW q on diplopia caused by lesion in trochlear nerve. It says the damage in trochlear nerve can cause "vertical" diplopia. so how is it diff from "horizontal" diplopia if there is such a thing. What would be the clinical symptoms of vertical vs. horizontal diplopia?

So any clinical vignette that says a pt is having a diplopia or double vision, it would be safe to assume trochlear lesion?

 

[faisal 2000]

trochlear lesion causes head tilting, extortion of eye, and vertical diplopia, while abducent lesion causes inability to abduct the eye, and horizontal diplopia