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At least 253 records · Page 14Linked to original sources
PubMed2001

Using diplopia as a warning of an inappropriate visual (ocular) accommodative response (WIVAR).

BACKGROUND: Over-accommodation, a tendency to focus at a distance closer than the desired distance, has been previously shown to occur when using a head-up display (HUD). METHODS: A simple system was developed as a warning of an inappropriate visual accommodative response (WIVAR) during flight training. Two lines, which are seen as four low-contrast lines (physiological diplopia) if the user is focused in the distance due to the link between convergence and accommodation, are projected onto the pilot's HUD combiner. RESULTS: The results show that by using the WIVAR system the accommodative response can be kept more distant when viewing forward-looking infra-red imagery (by 0.12 +/- 0.04 D; p < 0.05), performing a high cognitive workload task (by 0.07 +/- 0.03 D; p < 0.05) and especially when viewing in a Ganzfeld (by 0.41 +/- 0.12 D; p < 0.01). CONCLUSION: While collimated HUD imagery stimulates the user to a more distant focus, the use of the WIVAR lines can cause additional relaxation of accommodation.

Accommodation, Ocular↗
PubMed2000

Diplopia from skew deviation in Ramsey-Hunt syndrome. A case report.

OBJECT: Presentation of a 34-year-old pregnant woman with skew deviation due to peripheral vestibular dysfunction caused by herpes zoster oticus. METHODS: A multidisciplinary approach (neuroophthalmology, otorhinolaryngology, neuroradiology) revealed the diagnosis of Ramsey-Hunt syndrome. CASE REPORT: The patient presented with painful herpes zoster vesicles of the left ear, associated with a rotatory vertigo and hearing loss. Otorhinolaryngological examination showed a unilateral peripheral vestibular loss, a nystagmus towards the unaffected right side, no facial nerve dysfunction and a left perception hearing loss, mainly in the frequencies between 2-6 KHz. The patient was treated with Zovirax IV. Neuroradiological examination (MRI without contrast) revealed no abnormalities. Vertical diplopia from skew deviation was noted +/- 10 days after onset of herpes zoster oticus. Neuroophthalmological and orthoptic examination showed a comitant right hypertropia of 6 diopters and a spontaneous nystagmus to the right. CONCLUSION: Skew deviation can be caused by a sudden unilateral cochleo-vestibular loss as described by A.B. Safran. (4,6,7,8).

Acyclovir↗
PubMed1995

[Diplopia following local anesthesia].

In dentistry diplopia following injection of a local anaesthetic is a rare complication. A case is presented in which a patient developed a transient paralysis of a lateral rectus muscle. The literature concerning orbital involvement of local anaesthetics is discussed. The most likely explanation for the occurrence of these adverse effects is intra-vascular injection in the superior or inferior alveolar artery with backflow into the vessels supplying the orbit.

Anesthesia, Local↗
PubMed1975

[Diagnosis and therapy of post-traumatic diplopia (author's transl)].

The authors describe the diagnosis and operative methods for the treatment of 36 patients which were operated on in the last two years. These patients included 32 with various face fractures, of which 7 had blow-out fractures. In 4 patients the diplopia was caused by injuries to the soft tissues without bony fracture. The examinations comprised x-ray methods and also ophthalmological examinations, especially with the synoptometer. In 24 operated patients, reposition of the bony fragments or autologous bone grafts were done according to the kind of injury present. Although 17 patients were operated on very late (some weeks up to several months after the trauma), in 13 patients (54%) a complete cure could be achieved, and all the other patients showed an improvement. In 3 patients there was only a minor improvement, and it was decided to perform further operations on the extrinsic eye muscles. The authors emphasize the special sense of multi-disciplinary working together in the diagnosis and therapy of patients with face injuries, while this is very important for the success of the treatment.

Adult↗
PubMed2002

Diplopia as an initial manifestation of disseminated non-hodgkin's lymphoma.

A 37-year-old male presented a sudden diplopia. Ocular examination showed a partial paresis of the left eye (LE) on the left gaze, progressing in a few days towards a total ophthalmoplegia. Further investigation revealed an intra-orbital mass, immunohistologically diagnosed as a Diffuse Large B-cell Lymphoma (DLBCL), according to the WHO classification. Since the patient was in an advanced, disseminated stage of the disease (IVA-E), treatment was based on systemic and intrathecal chemotherapy with a pancranial radiotherapy. The clinical course was poor with only a 10-month survival. We wish to stress that the possibility of orbital malignancy in young adults with acute onset of ophthalmoplegia should be included in the differential diagnosis.

Adult↗
PubMed2003

[Diplopia as the first manifestation of Lyme disease].

CASE REPORT: We report a case of Lyme disease with diplopia as the first manifestation, without systemic symptoms in contrast with other cases of this disease. The serodiagnosis was confirmed by ELISA analysis and evaluation of cerebrospinal fluid (CSF) antibodies. Symptoms readily vanished after the introduction of antibiotherapy. DISCUSSION: Lyme disease is an infectious multi-systemic disorder caused by Borrelia burgdorferi. Neuro-ophthalmological manifestations occur during the second stage of the illness in extremely variable clinical forms.

Adult↗
PubMed2003

[57-year-old patient with diplopia and headache].

A 57-year old patient presented with an 8 week history of headache and diplopia. Left-sided incomplete oculomotor nerve paresis was found, whereas further clinically relevant visual impairment was not seen. Magnetic resonance imaging of the head showed an extensive intra-, para- and suprasellar tumor which in combination with a markedly elevated serum prolactin level was identified as a macroprolactinoma. The symptoms began 7 years ago with a loss of libido and virility. The application of a dopamine agonist lead to a reduction of serum prolactin level to 0.5% of the initial value and a considerable tumor regression within three months. The development of oculomotor nerve paresis is an unusual manifestation of prolactinoma. By contrast, long-term medical history with slowly developing signs and symptoms of hypogonadotropic hypogonadism are often to be found in men. The delayed diagnosis is responsible for the high percentage of macroprolactinomas in male subjects.

Diagnosis, Differential↗
PubMed2003

[Clinical analysis of the diplopia and strabismus after ophthalmic surgeries].

OBJECTIVE: To explore the mechanism and therapy of strabismus secondary to ophthalmic surgeries. METHODS: 79 cases of postoperative secondary strabismus were examined for eye position, eyeball movement, diplopia and ocular muscle traction test. Strabotomies were performed in some of the cases. Their involved extrocular muscle conditions were examined during the surgery. RESULTS: The cases of strabismus in the series were secondary to surgery of retinal detachment (38.0%), cataract extraction (31.7%), orbital surgery (13.9%), and other ophthalmic surgeries such as glaucoma, pterygium and blephatoptosis. Some cases secondary to surgery of retinal detachment and cataract extraction didn't recover in more than 6 months after surgery. The traction tests of involved muscles in some cases were positive. Fibrosis of the involved ocular muscles and adhesion of involved ocular muscles to conjunctiva, sclera and explants were found during strabotomies. Strabismus secondary to orbital surgery mainly showed impeding movement of eyeball. Strabismus secondary to pterygium mainly related to injury of the medial rectus operations. Strabismus secondary to glaucoma surgery recovered spontaneously in 2 - 14 days after operations. CONCLUSIONS: Intraocular or external ophthalmic surgeries can cause secondary strabismus. The mechanism is primarily due to direct injury of the extraocular muscles, impeding movement and mechanical compression to the eyeball. Surgeons should pay more attention for those side effects, and take effective therapy to prevent and treat iatrogenic strabismus.

Adolescent↗
PubMed2004

[Turning the head, an unusual mechanism to compensate for diplopia caused by abduction restriction of one eye].

A 59-year-old-man visited the neurological outpatient clinic because of a leftward rotation of his head for the last 8 months. This head deviation turned out to represent a compensatory mechanism to alleviate diplopia that resulted from an abduction restriction of his left eye. By turning his head into the direction of the weak left lateral rectus muscle, the patient could fixate both eyes on target and maintain binocular vision.

Diagnosis, Differential↗
PubMed1986

Monocular diplopia of retinal origin.

A 68-year-old man experienced monocular diplopia related to a subretinal choroidal neovascular membrane. His symptom resolved with laser photocoagulation of the choroidal membrane. Retinal disease is an uncommon cause of this uncommon symptom.

Aged↗
PubMed1979

Confusion, diplopia, and suppression.

Consideration of the clinical features and animal experimental models suggests that inhibition/suppression is not involved in anisometropic amblyopia. The role of suppression in anomalous correspondence needs further elucidation. Sensory testing in Duane's syndrome, where both BSV and suppression can be highly developed, confirms that diplopia may arise spontaneously at greater ages than previously suspected. The clinical time course of development of strabismic suppression is similar to that of the sensitive period during which binocularity can be established. Blakemore (1978) suggests that it may be more useful to think of a period of heightened sensitivity which tails off gradually. This concept would similarly apply to the time during which suppression may be established which does not have a sharp cut-off at 7 years of age.

Adolescent↗
PubMed1987

[Value of adjustable sutures in the treatment of diplopia].

Adjustable sutures have been used as a curative procedure in 31 cases of diplopia, 16 cases of plegic causes, 4 cases of acute concomitant squint and 11 cases of mechanical strabismus: thyroid myopathy, orbital fracture, oculomotor imbalance after scleral indentation. In oculomotor paralysis if a few functional motor units remained at plegic muscle level, we were able to obtain new rotational balance by combining, with adjustable sutures, recession and resection of the couple agonist-antagonist. On the other hand, if no functional motor unit remained, it was then necessary to turn to the muscular translocation process modulated by adjustable surgery. In acute concomitant strabismus, adjustable retroposition of the medial rectus enabled us to fall back into an area controlled by fusional vergencies. Lastly, in mechanical strabismus by passive limitation, adjustable sutures usually enabled hyperaction of the contralateral synergists to be controlled and to bind a new rotational balance, compatible with a simple binocular field of vision. The advantage of this technique was to adapt, on adjustment, the motor response to the new innervational background which had disappeared under anaesthesia.

Adolescent↗
PubMed1988

Elimination of monocular diplopia by corneal tattooing.

Corneal tattooing to eliminate monocular diplopia secondary to surgical peripheral iris defects was performed successfully in two patients who were unable to tolerate contact lenses. The technique is simple, safe, cosmetically satisfactory, and eliminates the need for patient compliance with contact lens care. Although corneal tattooing is usually considered to have only cosmetic value, these patients demonstrate that it can be therapeutic as well.

Aged↗
PubMed1987

Monovision correction for diplopia.

Acquired, incomitant strabismus frequently results in diplopia. Affected patients complain of chronic annoyance and frustration with the false image. Therapy has usually been aimed at either re-establishing binocularity by using prisms or vision training, or by eliminating one image through occlusion. An alternative approach is to allow each eye its own "domain," one eye corrected for distance vision and the other for near vision. This alternative may eliminate the competitive, unfusible images and yet maintain visual function in each eye.

Adult↗
PubMed1986

A clinical technique for correcting diplopia with prism.

We describe a technique to directly measure the angle and magnitude of any deviation, regardless of its direction. Knowing the angle and magnitude of an oblique deviation allows the clinician to find a prism correction faster and with more accuracy than by using the traditional method of combining vertical and horizontal prisms. We have applied this technique to 37 patients and have found a very high success rate using press-on or ground-in prism for both postsurgical and nonsurgical patients. All of the necessary materials are standard equipment for a routine eye examination. Even though a very similar technique has been described previously in the literature by another author, it does not appear to be known by many clinical optometrists. We hope the description of our technique will focus interest on this useful method for correcting very difficult diplopia cases.

Diplopia↗
PubMed1987

Diplopia and diabetes insipidus secondary to type II fracture of the sella turcica: case report.

Fractures of the sella turcica are rare and are often difficult to diagnose radiologically. They can produce a wide variety of complications, including septic, neuroendocrine, neurovascular and neuroophthalmologic problems. The authors describe the case of a 17-year-old boy with diabetes insipidus and diplopia secondary to a type II fracture of the sella turcica. They emphasize the clinical importance of fractures in the sellar region in view of their proximity to vital structures and they discuss possible mechanisms of causation.

Adolescent↗
PubMed1985

Diplopia.

Diplopia may be a presenting symptom of a wide variety of ocular and neurological conditions. Careful questioning and examination will reveal the cause in many cases and may save the patient much unnecessary and expensive investigation.

Accommodation, Ocular↗