Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Diplopia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources
PubMed2006

[Necrosis and reconstruction of the inferior oblique muscle after removal of a wooden intra-orbital foreign body].

A 39-year-old patient presented 3 days after a bicycle accident with a progressive left periorbital inflammatory swelling and diplopia in upgaze. On the day of the accident, a cranial x-ray did not reveal a fracture or an orbital foreign body, and the 2.5 cm skin wound on the left lower eyelid was sutured. For further evaluation, computer tomography) was performed. This did not show a radio-opaque, orbital foreign body. An explorative orbitotomy was carried out and revealed a 3.7 cm long wooden fragment medial to the inferior oblique muscle (OI). The extraconal portion of OI was found to be necrotic. Complete reconstruction of the OI was not possible due to the extent of the necrosis. The residual muscle was fixated to the orbital septum. Recovery was good and the diplopia resolved after 6 months. This case emphasizes the importance of a meticulous inspection of skin wounds with a high risk of remaining wooden foreign bodies and shows the possibility of functional recovery of extraocular muscles following partial reconstruction.

Adult↗
PubMed2003

Abducens nerve palsy as a rare complication of spinal surgery: a case report.

We describe a case of diplopia due to abducens nerve palsy after upper cervical spinal surgery. A 22-year-old woman presented with a chief complaint of numbness and weakness in her left hand. A spinal cord tumor was detected at the C1/2 level. These complaints disappeared after resection of the spinal cord tumor; however, she presented with diplopia due to abducens nerve palsy 3 days after surgery. Brain computed tomography and magnetic resonance imaging revealed no abnormalities. Within 1 month there was complete spontaneous resolution of the abducens nerve dysfunction. It is important for spinal surgeons to be aware of cranial nerve palsy as a potential complication of cervical spinal surgery.

Abducens Nerve Diseases↗
PubMed2006

[Secondary midfacial reconstruction using different surgical techniques and computer assisted surgery].

AIM: Aim of this retrospective study was to assess the outcome after secondary midfacial reconstruction using different operation techniques and computer assisted surgery. Functional and aesthetic aspects as well as experiences are reported. PATIENTS AND METHODS: 18 patients were assessed for enophthalmos, diplopia, and aesthetics during a follow-up period of up to 2.5 years. RESULTS: In 40% of the patients several techniques for soft and hard tissue reconstruction were used. In 5 of the 9 patients diplopia was improved; in 4 patients there was no change. A significant enophthalmos was corrected in 8 out of 12 patients. After additional surgery 6 patients had a good aesthetic result, 7 a satisfactory and 5 a poor. CONCLUSION: For secondary midfacial reconstruction often a combination of different surgical techniques is necessary. Bony asymmetries and enophthalmos were successfully corrected, however, functional and aesthetic impairment due to bad soft tissue condition are difficult to correct. Computer assisted surgery is helpful for dissection within the orbit, for graft placement, and for positioning of osteotomized segments.

Adolescent↗
PubMed1975

Ocular myasthenia gravis and Hashimoto's thyroiditis.

Two patients had ocular myasthenia gravis coexistent with Hashimoto's thyroiditis. A 37-year-old woman presented with diplopia and displayed a head tremor and thyroid enlargement. Thyroid function tests showed an elevated thyroid stimulating hormone (TSH). A quantitative Tensilon test yeilded a "perverse" response and a needle biopsy indicated Hashimoto's disease. A 26-year-old woman presented with diplopia and subsequently developed blepharoptosis and thyroid enlargement. Examination revealed Cogan's eyelid twitch sign, a paradoxical quantitative Tensilon test, and laboratory studies revealed normal thyroid function tests. Treatment was directed at each disease entity separately. Ocular myasthenia gravis was managed with an anticholinesterase agent in combination with oral corticosteroids that provided additional control. Suppressive therapy with desiccated thyroid hormone reduced the size of the thyroid gland, diminished the signs and symptoms of hypothyroidism, and lowered the levels of TSH, possibly decreasing the risk of thyroid carcinoma. Both patients showed gratifying responses to therapy.

Adult↗
PubMed1988

Fadenoperation for the management of complicated incomitant vertical strabismus.

We reviewed retrospectively the records of 17 patients with incomitant vertical diplopia secondary to an underacting inferior rectus muscle who had been treated by surgically weakening the contralateral inferior rectus muscle with a posterior fixation suture (fadenoperation). This was the sole procedure in four patients with blowout fractures and in two patients with restriction secondary to scleral buckling procedures. It was combined with horizontal or vertical muscle surgery in 11 patients. The procedure was particularly useful in preventing diplopia on downgaze after excessive weakening of a tight inferior rectus muscle in seven patients with thyroid ophthalmopathy. In three patients it was used in anticipation of an iatrogenic incomitancy in downgaze secondary to a large recession of a tight inferior rectus muscle. All patients were markedly improved after surgery and no complications were encountered.

Adult↗
PubMed1985

A retrospective study of treatment of orbital floor fractures with the maxillary sinus approach.

The Cook County Hospital, Chicago, Illinois, protocol for the management of orbital fractures is presented. Diplopia which fails to resolve in 1 week or appears after oedema subsides, enophthalmos or radiographic depression of the orbital floor, associated tripod fracture deformity, or purulent maxillary sinusitis are indications for surgery. The surgical procedure is a modification of the maxillary sinus approach, which includes the use of iodoform gauze packing, nasal antrostomy, a double layer oral closure and prophylactic antibiotics. A review of 102 patients treated surgically over a 6-year period is presented. Post-operative diplopia was 9% and there were minor complications in 3%, which were significantly lower than previously reported series of orbital fractures treated either non-operatively, or through an orbital exploration approach. No patient treated non-operatively required surgery in the future. The protocol presented can eliminate unnecessary exploration and yields excellent results with a simple surgical procedure.

Diplopia↗
PubMed1996

Loss of stereopsis in monkeys following prismatic binocular dissociation during infancy.

Prismatic binocular dissociation was used during infancy to mimic conditions of strabismus in macaque infants. Prisms worn continuously produce a diplopia unfavorable for the maintenance and development of the binocular visual system. Prism-reared monkeys were tested as young adults and found to be permanently stereoblind for dynamic random dot stereograms. Control monkeys did comparably to humans on such tests. It is concluded that short periods of diplopia attendant with strabismus are sufficient to produce permanent stereoblindness.

Age of Onset↗
PubMed1988

A retrospective study of untreated orbital blow-out fractures.

A retrospective study of 27 cases of untreated orbital blow-out fractures is presented. These patients were managed non-surgically because they presented with minimal ophthalmologic symptoms, or they sustained other injuries that prevented early repair. Twelve patients returned for follow-up examination and eight were contacted by telephone. In evaluating patients for diplopia, enophthalmos, hypesthesia, and restricted ocular movement, 85% showed complete resolution of symptoms. Based on these findings, surgical intervention is recommended only in those patients who demonstrate residual diplopia in primary gaze and restricted ocular motility that persist after 10 to 14 days, the presence of enophthalmos greater than 2 mm, and gross disruption of the orbital floor as confirmed by CT or tomography.

Adolescent↗
PubMed2004

Extraocular muscle enlargement with tendon involvement in thyroid-associated orbitopathy.

PURPOSE: To evaluate the configuration of extraocular muscle and tendon enlargement in patients with thyroid-associated orbitopathy (TAO). DESIGN: Retrospective, noncomparative case series. METHODS: We retrospectively evaluated the preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans, or both, of 125 consecutive patients with previously diagnosed TAO. Axial CT (n = 88) or MRI (n = 37) slices of the orbits were examined for tendon involvement of enlarged medial or lateral recti muscles. A ratio of tendon to muscle width greater than 0.5 was considered as tendon involvement. RESULTS: Eight patients (6.4%) with TAO demonstrated tendon involvement on axial CT or MRI. These patients had significantly greater diplopia in primary gaze than patients with no tendon involvement or patients with no muscle enlargement. CONCLUSION: The configuration of extraocular muscle enlargement on imaging studies has traditionally been used to differentiate TAO from other inflammatory processes because the tendon is typically spared (fusiform configuration) in TAO. However, we found that the configuration of tendon involvement (cylindrical configuration) can occasionally be noted in TAO and may be more frequently associated with primary gaze diplopia. Tendon involvement does not eliminate the diagnostic possibility of TAO.

Adult↗
PubMed2006

Transcaruncular orbital decompression: an alternate procedure for Graves ophthalmopathy with compressive optic neuropathy.

PURPOSE: To study the efficacy of transcaruncular orbital apex decompression for Graves ophthalmopathy with compressive optic neuropathy nonresponsive to pulse corticosteroids. DESIGN: Retrospective, interventional case series study. METHODS: From August 1999 to November 2003, transcaruncular orbital decompression was performed in 22 consecutive Graves ophthalmopathy patients with compressive optic neuropathy refractory to pulse corticosteroids. The average period of corticosteroid treatment was 16.1 +/- 5.2 days. Main outcome measures were preoperative and postoperative best-corrected vision, Hertel exophthalmometry, 100-hue color sensation test, visual evoked potential, visual field, and new-onset diplopia. RESULTS: Visual acuity improved significantly from 1.08 +/- 0.24 logarithm of minimal angle of resolution (logMAR) preoperatively to 0.29 +/- 0.18 logMAR postoperatively (P < .0001). Average improvement in retinal sensitivity was 9.4 +/- 8.2 dB, in P(100) value of visual evoked potential was 27.5 +/- 20.1, and in "total errors" of the 100-hue test was 309.9 +/- 214.3 after surgery. Average retroplacement effect was 3.7 +/- 1.6 mm. Statistical analysis showed significant differences between preoperative and postoperative measurements for all above parameters (P < .0001). New-onset diplopia occurred in 38% of patients. There were no complications specifically attributable to the transcaruncular technique. CONCLUSIONS: The transcaruncular approach offers access to the medial and inferior wall for orbital apex decompression in Graves ophthalmopathy patients with compressive optic neuropathy refractory to pulse corticosteroids. Advantages over other approaches included no external scar, less damage to adjacent tissue, and wide exposure to the entire medial wall.

Adult↗
PubMed2004

Monocular versus binocular vision in postural control.

OBJECTIVE: In previous studies about the control of posture there have been controversial findings. Our aim was to examine the role of monocular and binocular vision in controlling posture in quiet stance. METHODS: Twenty-eight normal subjects were tested. We used a force platform in measuring postural stability. In main experiment, postural stability was measured in four conditions: both eyes open (BEO), dominant eye open (DEO) non-dominant eye open (NDEO), and both eyes closed (BEC). In a further experiment, 11 subjects were tested in conditions where a vertical prism was placed in front of dominant eye. Prism was strong enough to cause diplopia. Our interest was to see, if diplopia affected the balance. RESULTS: In main experiment, at level of group the body-sway in any of the three ocular (viewing) conditions did not differ from each other. At level of individuals, binocular vision was more effective on controlling posture in only half of subjects. In prism experiment, relative to normal binocular viewing the postural stability was modified in both prism conditions, but there was no difference between monocular and binocular viewing with prism. CONCLUSION: In quiet stance and in subjects with perfect binocular vision and stereopsis, the benefit out of binocular viewing in postural stability is subject-dependent. At the level of group, monocular vision provides equally good postural stability as binocular vision.

Adult↗
PubMed2006

Transient abducens nerve palsy during endoscopic sinus surgery: report of three cases.

Dysfunction of one or more of the ocular motor nerves or extraocular muscle injury commonly results in diplopia. Diplopia during endoscopic sinus surgery is caused by surgical trauma or local anesthetics. Transient abducens nerve palsy rarely occurs after an intranasal sphenopalatine nerve block. We report three cases of transient abducens nerve palsy during endoscopic sinus surgery and possible explanations are proposed with a review of literature.

Abducens Nerve Diseases↗
PubMed2006

Efficacy of computer-assited surgery in secondary orbital reconstruction.

PURPOSE: In this study the efficacy of computer-assisted surgery (CAS) used for secondary orbital reconstruction after midfacial fractures was evaluated, comparing the clinical outcome with that after conventional surgery (CS). Special consideration was given to whether CAS can reduce the number of secondary corrections. PATIENTS AND METHODS: Twenty consecutive patients (24 orbits; 12 in each group) were assessed for enophthalmos, diplopia, and aesthetics during a follow-up period of up to 3 years. RESULTS: After CAS, enophthalmos was fully corrected in 8 of 11 orbits but after CS in only 6 of 10 orbits. Improvement of diplopia was achieved in 1 of 7 (CAS) and in 3 of 4 (CS) patients. The aesthetic result after secondary reconstruction and additional surgery was better in the CAS group. Additional surgery to correct bony structures was only necessary in 3 patients of the CS group. Additional soft tissue surgery was necessary in both groups. CONCLUSION: CAS can improve the clinical outcome of reconstructive bone surgery reducing the amount of additional hard tissue procedures. It was helpful during dissection of the scarred orbital tissue and placement of a graft. However, it had no impact on soft tissue correction especially with respect to function.

Adolescent↗
PubMed2006

A comparative study of 2 implants used to repair inferior orbital wall bony defects: autogenous bone graft versus bioresorbable poly-L/DL-Lactide [P(L/DL)LA 70/30] plate.

PURPOSE: The purpose of this study was to compare our clinical findings on the use of autogenous bone grafts and bioresorbable poly-L/DL-Lactide [P(L/DL)LA 70/30] implants to repair inferior orbital wall defects. PATIENTS AND METHODS: Thirty-nine patients who suffered orbital blow-out fractures with >or=2 cm2 bony defect in the inferior orbital wall took part in the study. Each inferior orbital wall was reconstructed using either an autogenous bone graft or a triangle form plate of P(L/DL)LA 70/30. Computed tomography scans were taken before the operation and at 2 and 36 weeks postoperatively. To describe the distribution of complications and facilitate statistical analysis, we categorized our findings into diplopia, enophthalmos, numbness, gaze restrictions, size of bony defect after treatment, bone growth, and implant resorption. A comparative study was carried out using chi2 test and the Fisher exact test. We considered P < .05 to be statistically significant. RESULTS: The clinical outcome was excellent in 19 of the 24 (79%) cases treated with autogenous bone grafts and in 13 of the 15 (87%) cases treated with P(L/DL)LA 70/30. No statistically significant differences were found between the 2 groups in overall type or number of complications. The most frequent type of complication found in both groups was enophthalmos, with 5 cases (bone graft, 3; P(L/DL)LA plates, 2). Diplopia was the second most frequent type of complication; however, both complications caused no need for the removal of the implants in either group. CONCLUSION: Autogenous bone grafts and P(L/DL)LA 70/30 implant plates do not present statistically significant differences in the parameters studied. Taking into account the availability and the advantages of P(L/DL)LA 70/30 implants when compared with autogenous bone grafts, our results allow us to conclude that there is no compromise regarding successful bridging of orbital floor defects using biodegradable P(L/DL)LA 70/30 osteosyntheses.

Absorbable Implants↗
PubMed2006

Strabismus after deep lateral wall orbital decompression in thyroid-related orbitopathy patients using automated hess screen.

PURPOSE: To evaluate the effect of deep lateral wall orbital decompression with intraconal fat debulking on strabismus in thyroid-related orbitopathy (TRO) patients using automated Hess screen (AHS). DESIGN: Prospective nonrandomized clinical study. PARTICIPANTS: Eleven TRO patients (19 surgeries) operated on at the Jules Stein Eye Institute from January, 2004, through December, 2004. METHODS: Automated Hess screen testing was performed in all patients before surgery and 3 months after surgery; all patients received surgery in the nonactive phase of the disease. MAIN OUTCOME MEASURES: Amplitude of horizontal and vertical deviations (prism diopters) in all standard positions of gaze. RESULTS: Eleven TRO patients (7 females; mean age, 47 years) were included in the study; 8 patients underwent bilateral surgery. After surgery, exophthalmos decreased an average (+/-standard deviation) of 2.7 mm (+/-2.5 mm; P = 0.003). Before surgery, 7 patients (63%) reported primary gaze diplopia, whereas only 2 patients (18%) showed diplopia in primary gaze after surgery (P = 0.03, chi-square analysis). Orbital decompression had no statistically significant effect on horizontal and vertical ocular deviations measured by AHS. Mean amplitude of deviation in primary gaze was 1.2 prism diopters (PD) esotropia and 0.07 PD hypotropia before surgery, and 2.5 PD exotropia with 0.6 PD hypertropia after surgery (delta = 3.7 PD for horizontal deviation and -0.7 for vertical deviation; P = 0.051, paired samples t test for horizontal difference and P not significant for vertical difference). Nonsignificant P values were obtained in all 9 positions of gaze. Most patients had periocular numbness that resolved spontaneously 2 to 6 months after surgery. CONCLUSIONS: Deep lateral wall orbital decompression with intraconal fat debulking had no statistically significant effect on horizontal and vertical deviations measured by the AHS. Patients may demonstrate small angle exotropia shift, but this finding was not clinically significant.

Adipose Tissue↗
PubMed2000

Pachymeningitis with pseudo-Foster Kennedy syndrome.

PURPOSE: To report a case of pachymeningitis with pseudo-Foster Kennedy syndrome in a patient who was positive for perinuclear antineutrophil cytoplasmic antibody. METHODS: Case report. A 44-year-old man was examined for headache and diplopia. RESULTS: Left eye showed limitation of abduction. Ocular fundus, computed tomography (CT), and magnetic resonance imaging (MRI) of the head and orbits were normal. The diplopia subsided spontaneously. Six months later, he noticed sudden visual loss in the left eye. The left eye showed optic disk atrophy and episcleritis, and the right eye showed papilloedema. Computed tomography and MRI exhibited thickened dura mater. Serum perinuclear antineutrophil cytoplasmic antibody level was highly increased. CONCLUSION: Pachymeningitis with ocular involvement sometimes requires repeated CT or MRI for diagnosis. This disorder may be caused by microvasculitis.

Adult↗
PubMed2001

Correction of cyclovertical strabismus induced by limited macular translocation in a case of age-related macular degeneration.

PURPOSE: To report a case of strabismus surgery performed to treat cyclovertical strabismus induced by limited macular translocation. METHODS: Case report. RESULTS: A 62-year-old man suffering with age-related macular degeneration and subfoveal choroidal neovascularization, RE, underwent limited macular translocation surgery. The fovea was rotated downward, and his visual acuity improved from 20/100 to 20/25 postoperatively. Cyclovertical diplopia persisted for 6 months after the operation. A Hess screen test revealed a pattern that simulated an underaction of the superior oblique muscle and inferior rectus muscle with an overaction of the ipsilateral inferior oblique muscle. To treat the diplopia, advancement of the superior oblique muscle tendon and resection of the ipsilateral inferior rectus muscle were performed. Binocular single vision with 140 seconds of arc for stereopsis was obtained. CONCLUSION: Cyclovertical strabismus after limited macular translocation is corrective with conventional surgery on the treated eye.

Choroidal Neovascularization↗
PubMed2001

Bilateral abducens nerve paresis associated with anti-GQ1b IgG antibody.

PURPOSE: To describe two cases with bilateral abducens nerve paresis associated with serum anti-GQ1b IgG antibody. METHODS: Case reports. RESULTS: Two boys, aged 12 and 10 years, experienced acute onset of diplopia after preceding symptoms and signs of infection. In both boys, examination showed only bilateral abducens nerve paresis. Although routine laboratory data and magnetic resonance imaging demonstrated no pathologic findings, titer of anti-GQ1b IgG antibody in the sera of both patients was increased. Diplopia and signs of bilateral abducens nerve paresis disappeared in 6 weeks without any specific treatment. CONCLUSION: The anti-GQ1b IgG antibody in the sera of both patients probably contributed to the bilateral abducens nerve paresis.

Abducens Nerve Diseases↗