Diplopia

From Anvita Health Wiki

Contents 1 Etiology 2 Management 3 More General Terms 4 References

Etiology

• horizontal diplopia:

• images side by side
• cranial nerve 3 or cranial nerve 6 dysfunction

• vertical diplopia

• images on top of another
• cranial nerve 3 or cranial nerve 4 dysfunction

• diplopia in one eye with the other eye closed

• suggests problem in the cornea or lens

• binocular

• extraocular muscle paralysis or weakness ( cranial nerve 3, cranial nerve 4, cranial nerve 6)

• diabetes
• posterior communicating artery aneurysm
• myasthenia gravis

• difficulty moving the eyes within the orbit

• tumor
• Graves' disease
• fracture

• pharmaceuticals [4]

• carbamazepine
• phenytoin
• vincristine

Management

• isolated cranial nerve 6 palsy can be observed for a few weeks looking for improvement
• with cranial nerve 3 palsies, absence of pupillary involvement suggests a benign process that may be observed over a couple of weeks
• most cranial nerve 4 palsies are traumatic or idiopathic postpone neuroradiology testing until 2 months have passed
• if more than one cranial nerve is involved, referral to a neurologist or ophthalmologist is indicated
• eye patch over affected eye can be useful if cause is benign [3]

More General Terms

• eye disease (ophthalmopathy)
• sign/symptom

References

1. Guide to Physical Examination & History Taking, 6th edition, Bates, B, JB Lippincott, Philadelphia, 1995, pg 35
2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
3. UpToDate, Online version 15.3 [1]
4. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society

diplopia (double vision)