Diplopia
Overview
Diplopia refers to double vision, which may be binocular (due to disordered conjugate gaze) or monocular.
Ask About
- Double vision as the patient moves their eyes. Identify whether this is on looking centrally, laterally, inferiorly or superiorly.
If diplopia is present, ask the patient to cover one eye. Determine whether the diplopia originates from a single eye (monocular), and whether the eyes are aligned.
Interpretation
- Monocular diplopiaCerebral polyopia, refractive error, retinal disease
- Non-misaligned - no strabusmus presentPhysiologic, macular disease, refractive asymmetry, multiple sclerosis, myaesthenia gravis
- Horizontal diplopia - double vision on lateral gaze associated with strabismus Intraocular / orbital mass, CN VI palsy, CNS lesion, Graves disease, myaesthenia gravis
- Vertical diplopia - double vision on superior / inferior gaze associated with strabismus Intraocular / orbital mass, CN III / IV palsy, CNS lesion, myaesthenia gravis
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