Which statement about skew deviation is accurate?

• A. It is horizontal eye misalignment due to inner ear infection
• B. It is vertical eye misalignment due to brainstem or cerebellar lesion
• C. It is a sign of cochlear damage
• D. It resolves with antihistamines

Answer: (B)

Skew deviation happens when there is a vertical misalignment of the eyes caused by disruption of the brainstem or cerebellar pathways that control eye alignment in response to gravity. This central origin means the misalignment points to a brain issue rather than a peripheral ear problem. That’s why describing vertical misalignment due to a brainstem or cerebellar lesion is the accurate statement. The other ideas don’t fit because inner ear infections affect peripheral vestibular function and typically cause vertigo with nystagmus, cochlear damage relates to hearing, and antihistamines don’t fix central ocular motor misalignment.