The superior oblique muscle allows the eye to be turned downward and inward. When the fourth cranial nerve is injured or diseased, it can cause paralysis of the superior oblique muscle.

The trochlear nerve, also known as cranial nerve 4 (CN IV), controls the superior oblique muscle in your eye. This muscle allows you to move your eyeball down and shift your gaze from side to side.

The trochlear nerve controls your superior oblique muscle. This is the muscle that’s in charge of downward, outward, and inward eye movements. It emerges from the back part of your midbrain.

Oblique muscle pain occurs due to oblique strains and tears, also known as side strain. This often occurs in sports, such as baseball or cricket, that require repetitive twisting and overarm movement.