eMedicine Specialties > Ophthalmology > Neurologic Disorders

Diplopia: Follow-up

Author: Izak F Wessels, MBBCh, MMed, FRCSE, FRCO, Associate Professor, Department of Ophthalmology, Chattanooga Unit, University of Tennessee College of Medicine; Private Practice in Comprehensive and Surgical Ophthalmology, Allied Eye Associates
Contributor Information and Disclosures

Updated: Nov 19, 2009

Follow-up

Further Outpatient Care

  • Further outpatient care is dependent on the type of diplopia (double vision) and the treatment started.

Complications

  • In infants and young children, diplopia can result in suppression and amblyopia of the nondominant eye.

Prognosis

  • The causes of diplopia can vary from a mild inconvenience to a condition with major health consequences.
    • As a rule, patients with diabetic mononeuritis multiplex recover spontaneously in approximately 6 weeks.
    • Optical causes (eg, lens dislocation, corneal disorders) are amenable to repair.
    • Blow-out fractures have a variable prognosis depending on the amount of tissue damage.
    • Central (neurologic) causes of diplopia can have serious consequences and, in the case of primary or secondary tumors, have a dire prognosis.

Patient Education

  • Patients must be educated on the importance of determining the exact cause of diplopia, since some conditions responsible for diplopia may be very serious. Otherwise, a clear explanation of the condition, its natural history, alternative options, and general prognosis will alleviate patient concerns and motivate perseverance.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Black Eye.

Miscellaneous

Medicolegal Pitfalls

  • Identifying the type of diplopia, as well as sharing thoughts and concerns with the patient, helps to reduce the medical/legal pitfalls. Although no published requirements exist for limiting driving or operating hazardous equipment while experiencing diplopia, it is obvious that the patient's depth perception and judgment may be severely limited by an inability of the eyes to function together, thereby implicating health care providers who neglect to provide timely warnings and cautions.

Special Concerns

  • Diplopia indicates a mature visual perception system. In young children, diplopia will result in suppression of one image and, if persistent, may result in permanent visual loss (amblyopia) in that eye. Compelling the use of both eyes in a timely fashion is critical. This can be achieved by patching or atropine penalization of the dominant eye and by implementing such therapy as indicated to remedy the cause of the diplopia and to permit visual development in both eyes.
 


More on Diplopia

Overview: Diplopia
Differential Diagnoses & Workup: Diplopia
Treatment & Medication: Diplopia
Follow-up: Diplopia
References
Further Reading
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References

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Further Reading

Guidelines

Amblyopia. American Academy of Ophthalmology.
Esotropia and exotropia. American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel.

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Keywords

diplopia, double vision, binocular diplopia, monocular diplopia, heteronymous diplopia, crossed diplopia, direct diplopia, homonymous diplopia, simple diplopia, physiologic diplopia, mental diplopia, blurred vision, seeing double

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Contributor Information and Disclosures

Author

Izak F Wessels, MBBCh, MMed, FRCSE, FRCO, Associate Professor, Department of Ophthalmology, Chattanooga Unit, University of Tennessee College of Medicine; Private Practice in Comprehensive and Surgical Ophthalmology, Allied Eye Associates
Izak F Wessels, MBBCh, MMed, FRCSE, FRCO is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Medical Editor

Andrew W Lawton, MD, Medical Director of Neuro-Ophthalmology Service, Section of Ophthalmology, Baptist Eye Center, Baptist Health Medical Center
Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Brian R Younge, MD, Professor of Ophthalmology, Mayo Clinic School of Medicine
Brian R Younge, MD is a member of the following medical societies: American Medical Association, American Ophthalmological Society, and North American Neuro-Ophthalmology Society
Disclosure: Nothing to disclose.

CME Editor

Ralph Garzia, OD, Assistant Dean for Clinical Programs, Associate Professor, School of Optometry, University of Missouri at St Louis
Ralph Garzia, OD is a member of the following medical societies: American Academy of Optometry and American Optometric Association
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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