Biomaterial Database

Binocular diplopia. A practical approach. 2005

Janet C Rucker, and Robert L Tomsak

Department of Neurology and Ophthalmology, Case Western Reserve School of Medicine, Cleveland, Ohio 44106, USA. janet.rucker@uhhs.com

BACKGROUND Diplopia is a common complaint in both inpatient and outpatient neurologic practice. Its causes are many, and special historical and examination features are important to localization and accurate diagnosis. RESULTS This review is divided into 2 sections: the first related to diagnosis and the second to treatment of binocular diplopia. In the diagnostic section, emphasis is placed on identification of historical and examination features that can help to differentiate diplopia caused by dysfunction of cranial nerves versus neuromuscular junction, or orbital extraocular muscle. Techniques available to the neurologist for examining ocular motility and ocular misalignment and focused laboratory testing to evaluate diplopia are discussed in detail. The final section covers the various treatments for binocular diplopia, with recommendations regarding the utility of each treatment for different types of diplopia. CONCLUSIONS A logical step-by-step approach applied to each patient with diplopia will help prevent misdiagnosis and improve patient care.

UI	MeSH Term	Description	Entries
D009886	Ophthalmoplegia	Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles.	Oculomotor Paralysis,External Ophthalmoplegia,Internal Ophthalmoplegia,Ophthalmoparesis,External Ophthalmoplegias,Internal Ophthalmoplegias,Ophthalmopareses,Ophthalmoplegia, External,Ophthalmoplegia, Internal,Ophthalmoplegias,Ophthalmoplegias, External,Ophthalmoplegias, Internal,Paralysis, Oculomotor
D009916	Orbital Diseases	Diseases of the bony orbit and contents except the eyeball.	Disease, Orbital,Diseases, Orbital,Orbital Disease
D003389	Cranial Nerve Diseases	Disorders of one or more of the twelve cranial nerves. With the exception of the optic and olfactory nerves, this includes disorders of the brain stem nuclei from which the cranial nerves originate or terminate.	Cranial Neuropathies,Cranial Neuropathies, Multiple,Neuropathies, Cranial,Cranial Nerve Disorders,Cranial Nerve Palsies,Nervus Cranialis Disorders,Cranial Nerve Disease,Cranial Nerve Disorder,Cranial Nerve Palsy,Cranial Neuropathy,Cranial Neuropathy, Multiple,Multiple Cranial Neuropathies,Multiple Cranial Neuropathy,Nervus Cranialis Disorder,Neuropathies, Multiple Cranial,Neuropathy, Cranial,Neuropathy, Multiple Cranial,Palsies, Cranial Nerve,Palsy, Cranial Nerve
D003937	Diagnosis, Differential	Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.	Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004172	Diplopia	A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE.	Double Vision,Polyopsia,Diplopia, Cortical,Diplopia, Horizontal,Diplopia, Intermittent,Diplopia, Monocular,Diplopia, Refractive,Diplopia, Unilateral,Diplopia, Vertical,Cortical Diplopia,Cortical Diplopias,Diplopias,Diplopias, Cortical,Diplopias, Horizontal,Diplopias, Intermittent,Diplopias, Monocular,Diplopias, Refractive,Diplopias, Unilateral,Diplopias, Vertical,Horizontal Diplopia,Horizontal Diplopias,Intermittent Diplopia,Intermittent Diplopias,Monocular Diplopia,Monocular Diplopias,Polyopsias,Refractive Diplopia,Refractive Diplopias,Unilateral Diplopia,Unilateral Diplopias,Vertical Diplopia,Vertical Diplopias,Vision, Double
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D020511	Neuromuscular Junction Diseases	Conditions characterized by impaired transmission of impulses at the NEUROMUSCULAR JUNCTION. This may result from disorders that affect receptor function, pre- or postsynaptic membrane function, or ACETYLCHOLINESTERASE activity. The majority of diseases in this category are associated with autoimmune, toxic, or inherited conditions.	Neuromuscular Junction Disorders,Neuromuscular Junction Toxic Disorders,Neuromuscular Transmission Disorders,Toxic Disorders, Neuromuscular Junction,Neuromuscular Junction Disease,Neuromuscular Junction Disorder,Neuromuscular Transmission Disorder