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Diplopia Follow-up

  • Author: Jitander Dudee, MD; Chief Editor: Andrew G Lee, MD  more...
 
Updated: Aug 16, 2016
 

Further Outpatient Care

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

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Complications

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

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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.

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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.[11]

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education article Black Eye.

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Contributor Information and Disclosures
Author

Jitander Dudee, MD MA Cantab(Hons), FACS, FRCOphth, Ophthalmologist, Medical Vision Institute, PSC

Jitander Dudee, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Society of Cataract and Refractive Surgery, Kentucky Medical Association, Royal College of Ophthalmologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Andrew G Lee, MD Chair, Department of Ophthalmology, Houston Methodist Hospital; Clinical Professor, Associate Program Director, Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch School of Medicine; Clinical Professor, Department of Surgery, Division of Head and Neck Surgery, University of Texas MD Anderson Cancer Center; Professor of Ophthalmology, Neurology, and Neurological Surgery, Weill Medical College of Cornell University; Clinical Associate Professor, University of Buffalo, State University of New York School of Medicine

Andrew G Lee, MD is a member of the following medical societies: American Academy of Ophthalmology, Association of University Professors of Ophthalmology, American Geriatrics Society, Houston Neurological Society, Houston Ophthalmological Society, International Council of Ophthalmology, North American Neuro-Ophthalmology Society, Pan-American Association of Ophthalmology, Texas Ophthalmological Association

Disclosure: Received ownership interest from Credential Protection for other.

Additional Contributors

Andrew W Lawton, MD Neuro-Ophthalmology, Ochsner Health Services

Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Izak F Wessels, MBBCh, MMed, FRCSE, FACS Adjunct Associate Professor, Loma Linda University; Private Practice in Comprehensive and Surgical Ophthalmology, Allied Eye Associates

Izak F Wessels, MBBCh, MMed, FRCSE, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, and Royal College of Surgeons of England

Disclosure: Nothing to disclose.

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.

References
  1. Rucker JC. Oculomotor disorders. Semin Neurol. 2007 Jul. 27(3):244-56. [Medline].

  2. Stager DR Sr, Black T, Felius J. Unilateral lateral rectus resection for horizontal diplopia in adults with divergence insufficiency. Graefes Arch Clin Exp Ophthalmol. 2013 Mar 22. [Medline].

  3. Migliorini R, Fratipietro M, Segnalini A, Arrico L. Persistent vertical diplopia after cataract surgery: a case report. Clin Ter. 2013. 164(1):e31-3. [Medline].

  4. Morris RJ. Double vision as a presenting symptom in an ophthalmic casualty department. Eye (Lond). 1991. 5 ( Pt 1):124-9. [Medline].

  5. Fraunfelder FW, Fraunfelder FT. Diplopia and fluoroquinolones. Ophthalmology. 2009 Sep. 116(9):1814-7. [Medline].

  6. Shah HA, Shipchandler TZ, Sufyan AS, Nunery WR, Lee HB. Use of fracture size and soft tissue herniation on computed tomography to predict diplopia in isolated orbital floor fractures. Am J Otolaryngol. 2013 Mar 22. [Medline].

  7. Murchison AP, Gilbert ME, Savino PJ. Neuroimaging and acute ocular motor mononeuropathies: a prospective study. Arch Ophthalmol. 2011 Mar. 129(3):301-5. [Medline].

  8. Hatt SR, Leske DA, Holmes JM. Comparing methods of quantifying diplopia. Ophthalmology. 2007 Dec. 114(12):2316-22. [Medline].

  9. Holmes JM, Leske DA, Kupersmith MJ. New methods for quantifying diplopia. Ophthalmology. 2005 Nov. 112(11):2035-9. [Medline].

  10. Phillips PH. Treatment of diplopia. Semin Neurol. 2007 Jul. 27(3):288-98. [Medline].

  11. Holmes JM, Liebermann L, Hatt SR, Smith SJ, Leske DA. Quantifying Diplopia with a Questionnaire. Ophthalmology. 2013 Mar 23. [Medline].

  12. Anderson MW, Sharma K, Feeney CM. Wound botulism associated with black tar heroin. Acad Emerg Med. 1997 Aug. 4(8):805-9. [Medline].

  13. Astin CL. The use of occluding tinted contact lenses. CLAO J. 1998 Apr. 24(2):125-7. [Medline].

  14. Batocchi AP, Evoli A, Majolini L, et al. Ocular palsies in the absence of other neurological or ocular symptoms: analysis of 105 cases. J Neurol. 1997 Oct. 244(10):639-45. [Medline].

  15. Berman EL. Clues in the eye: ocular signs of metabolic and nutritional disorders. Geriatrics. 1995 Jul. 50(7):34-6, 43-4. [Medline].

  16. Bielschowski A. Disturbance of vertical motor muscles of the eyes. Arch Ophthalmol. 1938. 20:175-200.

  17. Brazis PW, Lee AG. Binocular vertical diplopia. Mayo Clin Proc. 1998 Jan. 73(1):55-66. [Medline].

  18. Campbell C. Corneal aberrations, monocular diplopia, and ghost images: analysis using corneal topographical data. Optom Vis Sci. 1998 Mar. 75(3):197-207. [Medline].

  19. Capo H, Roth E, Johnson T, et al. Vertical strabismus after cataract surgery. Ophthalmology. 1996 Jun. 103(6):918-21. [Medline].

  20. Dengis CA, Steinbach MJ, Ono H, et al. Learning to look with one eye: the use of head turn by normals and strabismics. Vision Res. 1996 Oct. 36(19):3237-42. [Medline].

  21. Fingeret M. Forced duction test. Atlas of Primary Eyecare Procedures. Norwalk, Conn: Appleton & Lange; 1990. 138-44.

  22. Fowler MS, Wade DT, Richardson AJ, et al. Squints and diplopia seen after brain damage. J Neurol. 1996 Jan. 243(1):86-90. [Medline].

  23. Galimberti CA, Versino M, Sartori I, et al. Epileptic skew deviation. Neurology. 1998 May. 50(5):1469-72. [Medline].

  24. Gladstone GJ. Ophthalmologic aspects of thyroid-related orbitopathy. Endocrinol Metab Clin North Am. 1998 Mar. 27(1):91-100. [Medline].

  25. Goldenberg AS. Transient diplopia as a result of block injections. Mandibular and posterior superior alveolar. N Y State Dent J. 1997 May. 63(5):29-31. [Medline].

  26. Hahn JS, Berquist W, Alcorn DM, et al. Wernicke encephalopathy and beriberi during total parenteral nutrition attributable to multivitamin infusion shortage. Pediatrics. 1998 Jan. 101(1):E10. [Medline].

  27. Hayreh SS, Podhajsky PA, Zimmerman B. Occult giant cell arteritis: ocular manifestations. Am J Ophthalmol. 1998 Apr. 125(4):521-6. [Medline].

  28. Ing E, Kennerdell JS. The evaluation and treatment of extraocular motility deficits. Otolaryngol Clin North Am. 1997 Oct. 30(5):877-92. [Medline].

  29. Kasner SE, Liu GT, Galetta SL. Neuro-ophthalmologic aspects of aneurysms. Neuroimaging Clin N Am. 1997 Nov. 7(4):679-92. [Medline].

  30. Kolling GH. [Reflections on expert assessment of double vision and forced head position]. Klin Monatsbl Augenheilkd. 1996 Jan. 208(1):63-5. [Medline].

  31. Kushner BJ, Kowal L. Diplopia after refractive surgery: occurrence and prevention. Arch Ophthalmol. 2003 Mar. 121(3):315-21. [Medline].

  32. Kutschke PJ. Taking a history of the patient with diplopia. Insight. 1996 Sep. 21(3):92-5. [Medline].

  33. Lasley DJ, Kivlin J, Rich L, et al. Stereo-discrimination between diplopic images in clinically normal observers. Invest Ophthalmol Vis Sci. 1984 Nov. 25(11):1316-20. [Medline].

  34. Marzo ME, Perez Lopez-Fraile I, Capablo JL, et al. [Ocular myasthenia: clinical course and strategies for treatment]. Rev Neurol. 1998 Mar. 26(151):398-400. [Medline].

  35. Miller NR. Lesions of the supranuclear ocular motor pathways. Walsh and Hoyt's Clinical Neuro-Ophthalmology. 4th ed. Baltimore, Md: Lippincott Williams & Wilkins; 1985. 707-715.

  36. Muneer A, Jones NS, Bradley PJ, et al. ENT pathology and diplopia. Eye. 1998. 12 (Pt 4):672-8. [Medline].

  37. Ottar WL. Diplopia: double the fun! Part 1: History taking. Insight. 1998 Dec. 23(4):119-25. [Medline].

  38. Richardson LD, Joyce DM. Diplopia in the emergency department. Emerg Med Clin North Am. 1997 Aug. 15(3):649-64. [Medline].

  39. Safran AB, Vibert D, Häusler R. [Vestibular neuritis: a frequently unrecognized cause of diplopia]. Klin Monatsbl Augenheilkd. 1995 May. 206(5):413-5. [Medline].

  40. Schachat AP. Diplopia. Diagnostic Diagrams: Ophthalmology. Baltimore: Lippincott Williams & Wilkins; 1984. 101-107.

  41. Seminari E, Cocchi L, Antoniazzi E, et al. [Clinical significance of diplopia in HIV infection. Assessment of a personal caseload and review of the literature]. Minerva Med. 1996 Nov. 87(11):515-23. [Medline].

  42. Shumrick KA, Kersten RC, Kulwin DR, et al. Criteria for selective management of the orbital rim and floor in zygomatic complex and midface fractures. Arch Otolaryngol Head Neck Surg. 1997 Apr. 123(4):378-84. [Medline].

  43. Stangler-Zuschrott E. [Disturbing physiologic diplopia (author's transl)]. Klin Monatsbl Augenheilkd. 1979 Mar. 174(3):370-3. [Medline].

  44. Werner SC. Modification of the classification of the eye changes of Graves' disease: recommendations of the Ad Hoc Committee of the American Thyroid Association. J Clin Endocrinol Metab. 1977 Jan. 44(1):203-4. [Medline].

  45. Woods RL, Bradley A, Atchison DA. Monocular diplopia caused by ocular aberrations and hyperopic defocus. Vision Res. 1996 Nov. 36(22):3597-606. [Medline].

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