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Spontaneously observed physiologic diplopia seems to be a pathologic condition caused by a disturbance of high cerebral functions, especially of attention. In a personally observed case an organic psychosyndrome was present. The aetiology and an effective therapy are still unknown. Further studies of similar cases may promote explanation.
The author has presented a new method to correct vertical diplopia using a prism contact lens. To the present time, its application has been limited to contact lenses correcting refractive errors of less than 3D and to ground-in prisms of not more than 6 delta. The field is new. Technical, mathematical, and clinical advances should eventually allow the use of stronger prisms over a wider range of refractive corrections.
The emergency situations in ophthalmology are divided into the main symptoms (acute loss of sight, pain in the eye, "Red Eyes", injuries, unconsciousness, diplopia). Subjective symptom identification, diagnosis and current therapy are briefly outlined. For the general doctor the important preceding symptoms are emphasized as well as the prognosis according to clinical treatment.
The complication of extraocular muscle palsy following blepharoplasty is rare. In a review of 920 blepharoplasties at Manhattan Eye, Ear and Throat Hospital, three well-documented cases of diplopia following blepharoplasty could be found. Only one of these cases resolved within two months postoperatively. The explanation offered for this phenomenon is a Volkmann type contracture of the extraocular muscles following edema and hemorrhage into the muscle sheath.
A patient with an 8-month old orbital floor fracture presented with inferior displacement of the globe, enophthalpmus and diplopia on upward gaze due to an entrapped inferior rectus muscle. In a combined approach, the orbital floor was first repaired by an otorhinolaryngologist. The ophthalmologist then severed the adhesions of the inferior rectus muscle, and a piece of silicone sheeting was sutured to periorbital tissue under the muscle to prevent the formation of new adhesions as well as to provide a smooth surface for the muscle to slide on. This approach restored the muscle function which has remained intact 13 months postoperatively. The simplicity of the procedure is stressed.
Monocular diplopia is a symptom which may range from a visual curiosity to being visually dehabilitating. Its proper diagnosis and management presents a challenge to the clinician. A comprehensive review of the literature illustrates the multiple etiologies which may produce this complaint. Differential diagnosis is an important factor in the ultimate successful management of the problem, since the latter is to a degree etiology specific. Method of differential diagnosis and management options are discussed.
Extrapulmonary small cell carcinoma is being increasingly recognized as a distinct clinical entity. We report a patient with small cell carcinoma of the rectum metastatic to the brain, presenting with diplopia and inappropriate antidiuretic hormone syndrome.
The patient described, a 51-year-old woman, had diplopia and cephalgia of two weeks' duration. On admission, the radiologic evaluation revealed a mass in the sphenoid sinus, multiple lesions in the calvarium and a solitary lung mass. Biopsy of the lung mass revealed an atypical plasmacytic infiltration. Laboratory findings confirmed the diagnosis of light-chain myeloma presenting with a pulmonary plasmacytoma and cranial nerve involvement.
A 48-year-old man had symptoms of monocular diplopia following photorefractive keratectomy (PRK) for residual myopia after radial keratotomy. The cornea was characterized by a ring of subepithelial haze. A new type of corneal topography analysis that depicts areas of focal optical micro irregularity was used to diagnose the etiology of the optical symptoms.
We report two cases in which heteronymous, altitudinal visual field defects resulted in loss of fusion and transient overlap of preserved hemifields. This phenomenon resulted in complaints of diplopia similar to that described as "hemifield" slide previously described by temporal hemianopsias. These cases illustrate that generalized loss of fusion, and not the particular type of hemianopic field defect, is responsible for the symptoms known as hemifield slide.
A patient with hypercalcemia due to primary hyperparathyroidism presented with diplopia that resolved with surgical removal of his parathyroid adenoma and normalization of his serum calcium values. No previous report of this feature of hyperparathyroidism has been reported.
We used the Weiss' coordimeter for studying the fusional effort of 8 patients presenting asthenopic complaints and intermittent diplopia. This method allows us to compare the latent deviation of the visual axis with and without fusion. We analyse the comparative responses through the cases of two congenital superior oblique palsies, one esophoria and five exophoria. In seven out of the eight cases, we propose an appropriate prismatic treatment.
A prism can be an effective tool in the treatment of selected cases of vertical diplopia. To illustrate the foregoing, we present three cases.
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