Diplopia: Difference between revisions
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'''Binocular'''. | '''Binocular'''. | ||
If both eyes are impacted by diplopia, it is called binocular double vision (diplopia). Binocular diplopia occurs when someone with misaligned eyes sees an object, then it falls over the fovea in 1 eye and an extrafoveal location in the other eye. Normally, when someone sees an object, the image falls over the fovea of each eye, and a single image is recognized. The patient has visual blurring that clears up by covering either eye.<ref>Rucker JC, Tomsak RL. [https://pubmed.ncbi.nlm.nih.gov/15733332/ Binocular diplopia: a practical approach.] The neurologist. 2005 Mar 1;11(2):98-110.</ref> | If both eyes are impacted by diplopia, it is called binocular double vision (diplopia). Binocular diplopia occurs when someone with misaligned eyes sees an object, then it falls over the fovea in 1 eye and an extrafoveal location in the other eye. Normally, when someone sees an object, the image falls over the fovea of each eye, and a single image is recognized. The patient has visual blurring that clears up by covering either eye.<ref name=":1">Rucker JC, Tomsak RL. [https://pubmed.ncbi.nlm.nih.gov/15733332/ Binocular diplopia: a practical approach.] The neurologist. 2005 Mar 1;11(2):98-110.</ref> | ||
{{#ev:youtube|mad5RjiyNMI|300}}<ref>Informational - Differentiating Between Monocular and Binocular Diplopia. Available from: https://www.youtube.com/watch?v=mad5RjiyNMI</ref> | {{#ev:youtube|mad5RjiyNMI|300}}<ref>Informational - Differentiating Between Monocular and Binocular Diplopia. Available from: https://www.youtube.com/watch?v=mad5RjiyNMI</ref> | ||
== Causes == | |||
'''Monocular''' | |||
The causes of monocular diplopia are usually ophthalmological or intraocular pathology with refractive error, including Refractive error, Cataract, Media opacity, Iris injury, Macular disease, Primary or secondary visual cortex disorder (usually bilateral monocular diplopia), and Corneal disease (for example, irregular astigmatism).<ref name=":0" /> It also may occur due to behavioral (psychogenic) disorders, dry eye, or Dislocated lenses, to name a few. | |||
'''Binocular''' | |||
The most common cause of binocular diplopia is the neurologic cause.<ref name=":2">Glisson CC. [https://pubmed.ncbi.nlm.nih.gov/31584541/ Approach to diplopia.] CONTINUUM: Lifelong Learning in Neurology. 2019 Oct 1;25(5):1362-75.</ref> Cranial nerve palsies, especially [[abducens nerve]] (CN VI) are the most common causes of binocular diplopia.<ref>Merino P, Fuentes D, de Liaño PG, Ordonez MA. [https://pubmed.ncbi.nlm.nih.gov/28720313/ Binocular diplopia in a tertiary hospital: aetiology, diagnosis and treatment.] Archivos de la Sociedad Española de Oftalmología (English Edition). 2017 Dec 1;92(12):565-70.</ref> It also may occur due to Thyroid dysfunction, Aneurysm, Diabetes, Brain tumors and cancers, Multiple sclerosis, and Head injury, to name a few. | |||
== Evaluation == | |||
Diplopia may be the first symptom of life-threatening or serious vision neurologic disease, and its correct diagnosis are essential, with a careful history and clinical examination, the neurologist should be able to notice the patterns of diplopia that show the location of dysfunction.<ref>Dinkin M. [https://pubmed.ncbi.nlm.nih.gov/25099102/ Diagnostic approach to diplopia.] CONTINUUM: Lifelong Learning in Neurology. 2014 Aug 1;20(4):942-65.</ref> and differentiate diplopia caused by dysfunction of orbital extraocular muscle versus cranial nerves, or neuromuscular junction.<ref name=":1" /> The onset of diplopia is always sudden.<ref name=":2" /> | |||
<references /> | <references /> | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
Revision as of 01:53, 24 April 2022
Definition[edit | edit source]
Diplopia means seeing double, is a symptom with both ophthalmological and neurological causes.[1] The images may present themselves side by side, on top of one another, or both. This disorder can impact a person's balance, movement, and ability to read.
Types and presentation[edit | edit source]
Monocular.
If only one eye is impacted by diplopia, it is called monocular double vision (diplopia). When the patient covers the unaffected eye, diplopia persists, and when covers the affected eye, diplopia disappears.[1]
Binocular.
If both eyes are impacted by diplopia, it is called binocular double vision (diplopia). Binocular diplopia occurs when someone with misaligned eyes sees an object, then it falls over the fovea in 1 eye and an extrafoveal location in the other eye. Normally, when someone sees an object, the image falls over the fovea of each eye, and a single image is recognized. The patient has visual blurring that clears up by covering either eye.[2]
Causes[edit | edit source]
Monocular
The causes of monocular diplopia are usually ophthalmological or intraocular pathology with refractive error, including Refractive error, Cataract, Media opacity, Iris injury, Macular disease, Primary or secondary visual cortex disorder (usually bilateral monocular diplopia), and Corneal disease (for example, irregular astigmatism).[1] It also may occur due to behavioral (psychogenic) disorders, dry eye, or Dislocated lenses, to name a few.
Binocular
The most common cause of binocular diplopia is the neurologic cause.[4] Cranial nerve palsies, especially abducens nerve (CN VI) are the most common causes of binocular diplopia.[5] It also may occur due to Thyroid dysfunction, Aneurysm, Diabetes, Brain tumors and cancers, Multiple sclerosis, and Head injury, to name a few.
Evaluation[edit | edit source]
Diplopia may be the first symptom of life-threatening or serious vision neurologic disease, and its correct diagnosis are essential, with a careful history and clinical examination, the neurologist should be able to notice the patterns of diplopia that show the location of dysfunction.[6] and differentiate diplopia caused by dysfunction of orbital extraocular muscle versus cranial nerves, or neuromuscular junction.[2] The onset of diplopia is always sudden.[4]
- ↑ 1.0 1.1 1.2 Danchaivijitr C, Kennard C. Diplopia and eye movement disorders. Journal of Neurology, Neurosurgery & Psychiatry. 2004 Dec 1;75(suppl 4):iv24-31.
- ↑ 2.0 2.1 Rucker JC, Tomsak RL. Binocular diplopia: a practical approach. The neurologist. 2005 Mar 1;11(2):98-110.
- ↑ Informational - Differentiating Between Monocular and Binocular Diplopia. Available from: https://www.youtube.com/watch?v=mad5RjiyNMI
- ↑ 4.0 4.1 Glisson CC. Approach to diplopia. CONTINUUM: Lifelong Learning in Neurology. 2019 Oct 1;25(5):1362-75.
- ↑ Merino P, Fuentes D, de Liaño PG, Ordonez MA. Binocular diplopia in a tertiary hospital: aetiology, diagnosis and treatment. Archivos de la Sociedad Española de Oftalmología (English Edition). 2017 Dec 1;92(12):565-70.
- ↑ Dinkin M. Diagnostic approach to diplopia. CONTINUUM: Lifelong Learning in Neurology. 2014 Aug 1;20(4):942-65.
