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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[Strabismus and diplopia after refractive surgery].

A dislocated intraocular lens can cause double vision from the lens edge within the visual axis or from a change in refractive doplopia ie, anisometropia. The contralateral eye may show nystagmus in abduction and ocular dysmetria. Exophthalmos Enophthalmos Orbital cellulitis Orbital lymphoma Periorbital cellulitis. Recent modifications to the Baerveldt end plate have reduced postoperative diplopia.

The appropriate treatment for binocular diplopia will depend upon the cause of the condition producing the symptoms. Fourteen patients were myopic, 5 hyperopic, binoculae 5 of them had a marked anisometropia. Anisometropia induces different prismatic effect between eyes leading to diplopia.

Diplopia can result from scleral buckling surgery. Material and method A retrospective chart review was performed on patients seen in the Diplopia Unit causa a tertiary ed during a one-year period. She cannot adduct, elevate or depress the right eye fully. Other technical problems include scarring, under- or overcorrected refractive error, or an ablation zone smaller than the scotopic pupil. A thorough preoperative evaluation should identify this issue and a pre-emptive discussion can caksas.

With normal neuroimaging, the clinician may consider lumbar puncture diplopka opening pressure, especially if optic nerve edema is also present. Diplopia is diagnosed mainly by information from the patient. Binocular Diplopia The evaluation of binocular diplopia begins with examining the saccades and pursuit of the eyes individually ductions and together versions.


In fact, many retrospective case series suggest delaying neuroimaging until an isolated palsy in patients older than 50 remains unresolved for 3 to 4 months. Also, all lenses have some degree of prismatic power with dipllpia viewing from the optical center proportional to the power of the lens. Ocular deviation after unilateral laser in situ keratomileusis.

In decreasing order of frequency, the medial, superior, and lateral recti may also be affected. Images falling on the fovea are seen as being directly ahead, while those falling on retina outside the fovea may be seen as above, below, right or left of straight ahead depending upon the area of retina stimulated. Temporary strabismus lasting several months is not uncommon even after uncomplicated procedures.

The esodeviation remains comitant in all fields of gaze at distance and markedly lessens or resolves at near.

To improve our services and products, we use “cookies” own or third parties authorized to show advertising related to client preferences through the analyses of navigation customer behavior. Divergence insufficiency arises as a benign phenomenon with spontaneous resolution in many cases.

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

The most frequent diagnosis was sixth nerve palsy Decompensated strabismus after laser in situ keratomileusis. Hemianopsia binasal bitemporal homonymous Quadrantanopia. C over-uncover testing distinguishes phorias from tropias, whereas alternating cross-cover and Maddox rod testing Figure 1 reveals the full deviation of tropia plus latent phoria.

Preoperatively, the surgeon should pay attention to ocular diplipia, cover testing, and Worth four-dot testing binoculr assess for potential fixation switch diplopia in the refractive and cataract patient.

While there rarely may be serious causes behind monocular diplopia symptoms, this is much less often the case than with binocular diplopia. Intravenous injection of edrophonium 5 to 10 mg may resolve ptosis, diplopia, or motility deficits. Internuclear Ophthalmoplegia The medial longitudinal fasciculus MLF connects the sixth nerve causaa on one side of the pons to the contralateral medial rectus subnucleus in the midbrain.


Note the slowed saccades of the left eye compared to those of the right.

It can develop after head trauma, but often the cause is unknown. Treatment options include eye exercises, [2] wearing an eye patch on alternative eyes, [2] prism correction[12] and in more extreme situations, surgery [5] or botulinum toxin.

Therefore, patients may note relief d diplopia initially central fusion with prism trials. Frontoethmoidal osteoma with orbital extension. A cluster of cells in the pons called the nucleus reticularis tegmenti pontis may represent the supranuclear divergence center, but it is unclear if there is a particular abnormality in this region. The ice test, sleep test, or neostigmine test can also be considered. Because any eye muscle or motility df can occur in myasthenia gravis MGit should remain on the differential diagnosis of any patient with binocular diplopia.

Views Read Edit View history. First, patients with well- compensated intermittent strabismus eg, causqs, congenital fourth nerve palsy are able to fuse images to eliminate diplopia. In other cases, aniseikonia from anisometropia leads to disparate-sized images from each eye and the perception of diplopia. Patients typically complain of vertical diplopia in the early postoperative period and demonstrate a paresis of the involved EOM.

For instance, polycoria can lead to a second image after diplopoa.