Diplopia is the simultaneous perception of two images of a single object that may be displaced in relation to each other. Also called double vision, it is a loss of visual focus under regular conditions, and is often voluntary. However, when occurring involuntarily, it results from impaired function of the extraocular muscles, where both eyes are still functional, but they cannot turn to target the desired object. Problems with these muscles may be due to mechanical problems, disorders of the neuromuscular junction, disorders of the cranial nerves (III, IV, and VI) that innervate the muscles, and occasionally disorders involving the supranuclear oculomotor pathways or ingestion of toxins.
| Diplopia | |
|---|---|
| Other names | Double vision |
| One way a person might experience double vision | |
| Specialty | Neurology, ophthalmology |
Diplopia can be one of the first signs of a systemic disease, particularly to a muscular or neurological process, and it may disrupt a person's balance, movement, or reading abilities.
Presentation
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Causes
Diplopia has a diverse range of ophthalmologic, infectious, autoimmune, neurological, and neoplastic causes:
- Abscess
- Aniseikonia
- Anisometropia
- Antipsychotics (haloperidol, fluphenazine, chlorpromazine etc.)
- Atypical parkinsonisms, especially multiple system atrophy and progressive supranuclear palsy
- Botulism
- Brain tumor
- Cannabis
- Cancer
- Damaged third, fourth, or sixth cranial nerves, which control eye movements
- Cataract
- COVID-19
- Diabetes
- Drunkenness
- Fluoroquinolone antibiotics
- Graves disease
- Guillain–Barré syndrome
- Keratoconus
- Lasik complications
- Lyme disease
- Migraine headaches
- Multiple sclerosis
- Myasthenia gravis
- Myalgic encephalomyelitis/chronic fatigue syndrome
- Opioids
- Orbital myositis
- Papilledema
- Trauma
- Sagging eye syndrome (SES)
- Salicylism
- Sinusitis
- Strabismus
- Thyroid eye disease (TED)
- Wernicke's syndrome
- Increased intracranial pressure (compressing the sixth cranial nerve results in diplopia)
Further reading
- Fraine L (2012). "Nonsurgical management of diplopia". The American Orthoptic Journal. 62: 13–18. doi:10.3368/aoj.62.1.13. PMID 23002469. S2CID 218549699.
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