Chapter 21 – Diplopia. Episode overview: 1) List the differential diagnosis (critical emergent, urgent) for Diplopia. ▫ Including at least 7 causes of binocular. Transcript of DIPLOPIA BINOCULAR Puede tener diversas causas, especialmente una serie de enfermedades y trastornos de los músculos. Las causas más frecuentes de diplopía binocular fueron las parálisis de los nervios craneales, especialmente del vi, seguidas de estrabismos descompensados.

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The inferior rectus is the EOM most commonly affected, and patients may complain of vertical double vision unless they adopt a chin-up face position.

Therefore, patients may note relief of diplopia initially central fusion with prism trials. The evaluation of binocular diplopia caksas with examining the saccades and pursuit of the eyes individually ductions and together binocullar. This relationship also gives rise to an associated phenomenon of binocular diplopia, although one that is rarely noted by those experiencing diplopia: Base-in reading glasses are not helpful in children and adolescents but may be effective in older patients.

Occlusion of the vision in one eye remains the easiest and most conservative treatment of binocular diplopia.

[Strabismus and diplopia after refractive surgery].

Strabismus induced by radial keratotomy. The encircling element may compress an EOM and functionally alter its action or restrict contraction of the muscle.

Retrieved from ” https: Anisometropia induces different prismatic effect between eyes leading to diplopia. From Monday to Friday from 9 cauusas. This correlation of particular areas of the retina in one eye with the same areas in the other is known as retinal correspondence.


Other mimickers of fourth nerve palsy include skew deviation, myasthenia gravis, and thyroid eye disease.

Diplopia – Wikipedia

Images falling on the fovea are seen as being directly ahead, while those falling on binocylar outside the fovea may be seen as above, below, right or left of straight ahead depending upon the area of retina stimulated.

Many supranuclear disorders do not cause diplopia, because ophthalmoplegia is symmetric between the eyes. Conclusions The most frequent causes of diplopja diplopia were cranial nerve palsies, especially the sixth cranial nerve, followed by decompensated strabismus. Monovision correction may render some patients diplopic by two mechanisms.

Infobox medical condition new.

Evaluation and Management

First, patients with well- compensated intermittent strabismus eg, exophoria, congenital fourth nerve palsy are able to fuse images to eliminate diplopia. Some patients may have relative pupil sparing where the affected pupil is larger 0. Diplopiacommonly known as double visionis the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, diagonally i.

Tapering the dose becomes difficult, because symptoms xe quickly and the risk of long-term adverse effects of corticosteroids arises. The affected eye retracts with adduction.

Some people are able to consciously uncouple their eyes, either by over focusing closely i. Ductions are full without evidence of abduction deficit. If these tests return negative and clinical suspicion remains high, then conventional catheter angiography should be ordered.

Double Maddox rod testing and funduscopy show excyclotorsion of the ipsilateral eye Figure 4a. Dragged-Fovea Diplopia Syndrome Maculopathies such as epiretinal membranes can anatomically pull one fovea out of correspondence with the fellow fovea. Subscribe to our Newsletter. Internuclear Ophthalmoplegia The medial longitudinal fasciculus MLF connects the sixth nerve nucleus on one side of the pons to the contralateral medial rectus subnucleus in the midbrain.


Local anesthetics can cause myotoxicity from diffusion into a muscle or more likely from direct injection. Ophthalmoplegia secondary to a neuropathy, myopathy, or neuromuscular junction disorder reveals slowed saccades. Ocular deviation after unilateral laser in situ keratomileusis.

Table 3 from [Strabismus and diplopia after refractive surgery]. – Semantic Scholar

Dacryoadenitis Epiphora Dacryocystitis Xerophthalmia. However, the following conditions may result from supranuclear disruption and often cause diplopia. A careful refraction including retinoscopy may reveal previously unidentified or irregular astigmatism from corneal or duplopia causes. Evaluation and Management Monocular Diplopia For the most part, patients with monocular diplopia do not warrant a neurologic evaluation since a careful ophthalmic evaluation will reveal the cause see Bihocular 1.

To study the causes, diagnosis and treatment in a case series of binocular diplopia. Also, the need for overcorrected myopia to control intermittent exotropia may go unrecognized by the refractive surgeon.

Neuroimaging is often unrevealing but can be initiated if the palsy does not remit. Ocular torsion and head tilt may accompany a skew deviation ocular tilt reaction [OTR].