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PubMed1988

The loss of fusion in adults with intractable diplopia (central fusion disruption).

People over the age of 10 years can lose their fusion ability. This acquired disruption of fusion gives rise to intractable diplopia without suppression. An involuntary vertical bobbing movement of the non-fixing eye, present only with both eyes open, occurs at or near the angle of superimposition. This appears to be a unique and characteristic sign of acquired disruption of fusion and was present in all cases. Other causes of diplopia are mentioned and differentiated. Acquired central fusion disruption usually results from serious head injury. Partial recovery may occur but is unlikely. Sensory deprivation of at least 3 1/2 years' duration due to poor vision in one eye resulting from a traumatic cataract and sometimes subsequent uncorrected unilateral aphakia caused loss of fusion in 15 patients. The practical implications with regard to intraocular lenses and unilateral aphakia is discussed. Less commonly, vascular, neoplastic and presumed inflammatory lesions in the mid-brain area cause central fusion disruption.

Adult↗
PubMed1980

Diplopia in the aged: etiology and management.

A description of diplopia, its causes, compensating mechanisms, and therapy is presented. Diplopia may be of benign origin, e.g., presbyopia or convergence insufficiency, but in the elderly it can be a warning of a severe local disorder or systemic disease. Early medical diagnosis should be a prime objective. Most of these disorders, if identified in time, can be cured or at least relieved by appropriate medical and surgical treatment.

Aged↗
PubMed1998

Decreased visual acuity and Diplopia in a patient with münchausen syndrome.

A 20-year-old woman complained of decreased visual acuity in her left eye and diplopia. She had visited several hospitals previously. On examination, her left visual acuity varied, and her squint angle also changed. No organic disorders that could have caused the symptoms were noted. She complained of edema of her left arm. On admission to another hospital, her arm was found bound tightly with tape. She wanted surgery to correct her esotropia but did not expect to improve her quality of life by having it done. We believe that our patient may have Münchausen syndrome and that the decreased visual acuity and diplopia may be a rare association with the syndrome.

Adult↗
PubMedDate not supplied

Conservative treatment of vertical diplopia in a patient with silent sinus syndrome.

Silent sinus syndrome is a rare disease of the maxillary sinus characterized by bony absorption processes leading to progressive sinus wall thinning with consecutive enophthalmos and hypoglobus. It represents a benign cause of acquired enophthalmos and is often accompanied by painless vertical diplopia, the latter treated surgically in all cases published to date. We report a 56-year-old patient with silent sinus syndrome in whom vertical diplopia was treated with prisms showing that conservative treatment alone may, in mild cases, be an effective alternative to reconstructive surgery.

Diplopia↗
PubMed1996

Diplopia from skew deviation in unilateral peripheral vestibular lesions.

Vertical diplopia from skew deviation is well described in brainstem lesions. The phenomenon can also result from peripheral vestibular lesions. During the past years, we have observed these ocular changes in the acute stage following unilateral vestibular neurectomy and labyrinthectomy (n = 13), as well as in series of patients suffering from idiopathic sudden unilateral peripheral vestibular or cochleo-vestibular deficit (n = 5). Diplopia from skew deviation was noted immediately following ablative vestibular procedures; in patients with idiopathic vestibular deficit, it was observed as an associated sign. In all patients, clinical evaluation revealed an acute unilateral peripheral vestibular loss, with spontaneous nystagmus toward the unaffected ear and absence of nystagmic response to caloric testing on the affected ear. Skew deviation was measured using the Hess-Weiss test, which is based on the haploscopic principle. Static visual vertical was evaluated with the original methods of vertical frame and Maddox rod techniques. Photographs were made of the ocular fundi, to measure the degree of cyclotorsion of both eyes. In our patients, we found skew deviation with hypotropia of the eye that was ipsilateral to the affected ear and conjugated cyclotorsion and tilt of the static visual vertical on the side of the affected ear. Skew deviation was the first sign to disappear within a few days; conjugated cyclotorsion and tilt of the static visual vertical persisted for weeks to months. The eye-head postural reaction, consisting of head tilt, conjugated eye cyclotorsion, skew deviation, and alteration of vertical perception directed toward the side of the lesion, is known as the Ocular Tilt Reaction (OTR). The mechanism is presumably related to a lesion of the otolithic organs and/or to changes in the afferent graviceptive pathways. In man, the OTR is often mild and unrecognized, masked by spontaneous nystagmus and marked neuro-vegetative symptoms. Our observations indicate that skew deviation, as a part of the OTR, occurs in patients with sudden peripheral vestibular lesions, whether surgical or non-surgical in origin.

Adult↗
PubMed1999

Acquired binocular horizontal diplopia.

Binocular horizontal diplopia is an important symptom that may foretell or help localize and characterize various neurologic and neuromuscular disorders. An appropriate evaluation requires a careful and complete neuro-ophthalmic history and examination. This review focuses on the differential diagnosis of binocular horizontal diplopia.

Central Nervous System Diseases↗
PubMed1999

Transient vertical diplopia and silent sinus disorder.

A 57-year-old man had isolated transient recurrent vertical diplopia. Left hypoglobus and enophthalmos were present. Investigations revealed an otherwise asymptomatic left maxillary chronic aspecific sinusitis, with 8 mm lowering of the left orbital floor. Transient diplopia was thought to be secondary to transient fusion impairment. Orbital floor reconstruction cured the patient.

Diplopia↗
PubMed2001

The eye in neurology: evaluation of sudden visual loss and diplopia--diagnostic pointers and pitfalls.

The evaluation of sudden visual loss should begin with the differentiation between monocular loss and binocular loss. The importance of this is reflected in the differences between the main causes of monocular and binocular losses. In cases of transient monocular visual loss, an ocular cause has to be kept in mind so as to avoid unnecessary and costly cerebrovascular investigations. In cases of persistent monocular visual loss, a compressive lesion of the optic nerve or chiasma may simulate optic neuritis. In the evaluation of diplopia, the main differential diagnoses are nerve lesions and myasthenia. The main causes of nerve lesions responsible for diplopia and their workup are summarised. The usefulness of eye signs in the diagnosis of myasthenia is highlighted. The possibility of compressive lesions co-existing with or masquerading as myasthenia is emphasised.

Diplopia↗
PubMed2003

A huge osteoma of paranasal sinuses with intraorbital extension presenting as diplopia.

Osteoma of the paranasal sinuses is a benign, well-defined and slow-growing tumor arising most commonly from the frontal sinus. The ethmoid and maxillary sinuses are less frequently involved. Very seldom, it may involve the orbit, usually by direct extension from the adjacent paranasal sinuses. We report a case of a huge osteoma in right ethmoid and maxillary sinuses with orbital extension that was accompanied by diplopia in a 20-year-old, previously healthy man. An external approach to the involved sinuses was utilized to remove the tumor completely after a successful maxilloethmoidectomy. The pathologic report confirmed the clinical diagnosis of osteoma. The patient fared well after surgery and his diplopia resolved without any definite cosmetic complications. No residual tumor was found during post-operative follow-up.

Adult↗
PubMed2005

[New method of prismatic prescription in diplopia].

This paper presents the case of a man with resulting diplopia due to multiple lesions of the extraocular muscles after an orbital trauma. The intact ocular globe has an horizonto-vertical strabismus. Purpose was the reduction of diplopia in primary gaze. The original contribution of the authors is the new method of prescription for the prismatic lenses, for the best results in glasses execution. A mathematical model of vectorial composition for light deviation through a system of prismatic lenses, is proposed.

Adult↗
PubMed2005

Nasopharyngeal tuberculosis: a case report presenting with diplopia.

Tuberculosis (TB) is a common infectious disease worldwide. It can affect many organs, the most common is lungs infection. Upper respiratory tract involvement is uncommon and the least common regional involvement is nasopharyngeal region. The authors report a case of nasopharyngeal tuberculosis who came with diplopia which is a very rare presentation. Nasopharyngeal tuberculosis is a rare condition that is found in only reported cases in the literature. In Thailand, the present case is the second case of this condition with diplopia. Nasopharyngeal examination reveal mass or ulceration. The diagnostic tool is lesional biopsy. Histology is necessary to diagnose tuberculosis and to exclude other conditions especially nasopharyngeal cancer Nasopharyngeal tuberculosis has a good prognosis after treatment.

Adult↗
PubMed1990

[Our experience with surgical treatment of post-traumatic diplopia].

On the basis of analysis of patients with posttraumatic diplopia pathomechanism, diagnostic procedure, methods of surgical treatment and its results were discussed. In the group of 1196 patients with injuries of the organ of vision posttraumatic diplopia was diagnosed in 536 (44.8%) patients, of which 331 (61.8%) underwent surgery. In this group recovery was obtained in 182 (55.0%) patients, while in remaining marked improvement was stated. Lack of knowledge in this field among specialists was pointed out and was confirmed by mistakes in diagnostics and methods of treatment. These factors markedly worsen final results of proper treatment.

Adolescent↗
PubMed1989

Postoperative diplopia, also in children.

Permanent diplopia caused by strabismus surgery can also occur in children. In certain cases we see an analogy with the feared and well known persistent diplopia that can occur after anti-suppressive therapy. This article discusses some of these cases and their treatment.

Adolescent↗
PubMed1985

Fresnel prism correction for trauma-induced diplopia.

Fresnel prisms placed on the spectacle lenses of a patient with optic atrophy resulting from an accident eliminated constant diplopia in the remaining visual field. A reduction in vision due to Fresnel prisms was found to be more tolerable than diplopia.

Diplopia↗
PubMed1978

[Diplopia in monocular aphakia].

In monocular aphakia, diplopia results from disparities between the two retinal images in form, size, outline, luminous intensity and colour. If one wishes to give the best binocular vision possible to a monocular aphake, it is important to recognize the different factors which may give rise to diplopia.

Aniseikonia↗
PubMed1984

Diplopia following Jones tube placement.

Diplopia following Jones tube placement is a rare complication. A 67-year-old female with diplopia was treated four months after Jones tube placement by incising conjunctival tension bands. To the best of our knowledge, this is the first report of treatment of this problem.

Aged↗
PubMedDate not supplied

Evaluating diplopia with the Maddox rod, Risley's prism, and red glass.

1. Using Maddox rod, Risley's prism, and red glass techniques can provide the doctor with the information needed to diagnose the reasons for diplopia. 2. The Maddox rod and Risley's prism help to determine misalignment in primary position. The red glass test provides valuable information on the type of muscle problems in all other fields of gaze. 3. Both tests should be used for any patient complaining about recent symptoms of diplopia.

Diplopia↗