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Brain and Nerve = Shinkei Kenkyu No... Dec 2018Here, I review the efficacy of radiological methods in the diagnosis of diplopia/double vision. The simplest technique for achieving a successful diagnosis is to capture... (Review)
Review
Here, I review the efficacy of radiological methods in the diagnosis of diplopia/double vision. The simplest technique for achieving a successful diagnosis is to capture a wide field-of-view image. In order to start the process of diagnosis, it is fundamental to first study the image findings. Analysis based on the principle of MECE or mutually exclusive collectively exhaustive is performed using four methods: deductive reasoning, fractionation, longitudinal study, and priority setting. The conventional practical procedure to attain a diagnosis is as follows. First, identify the location of the lesion by imaging, which will shorten the list of differential diagnosis. Second, obtain as much information as possible on the characteristics of the lesion in order to determine the pathology. Third, look for any associated findings, such as tortuous vasculature around the brain. Fourth, refer to all the available information; for example, the main complaint, clinical history, previous history, family history, physical findings, physiological findings, laboratory data, previous images, and other modalities. Finally, if still in doubt, one should consult with colleagues and the attending physician. However, because rationality (statistical analyses, such as posterior probability or positive predictive value with positive findings), predicted utility, and emotions play a factor in a person's decision making, it seems impossible to completely avoid oversights and misdiagnosis.
Topics: Brain; Decision Making; Diagnosis, Differential; Diplopia; Humans; Longitudinal Studies
PubMed: 30523215
DOI: 10.11477/mf.1416201193 -
Survey of Ophthalmology 2023A 14-year-old boy with a history of shunted congenital hydrocephalus began having headaches with nausea and vomiting after transcontinental flights. He gradually...
A 14-year-old boy with a history of shunted congenital hydrocephalus began having headaches with nausea and vomiting after transcontinental flights. He gradually developed horizontal diplopia indicative of mild bilateral sixth nerve palsy, without papilledema or ventriculomegaly. Intracranial pressure monitoring showed no signs of elevation. After he subsequently developed papilledema, surgical exploration showed shunt malfunction, and shunt replacement produced rapid resolution of symptoms. This case demonstrates the importance of relying on clinical history and neuro-ophthalmologic examination in patients with hydrocephalus and suspected shunt failure, even when objective confirmatory evidence of intracranial pressure elevation is lacking.
Topics: Male; Humans; Adolescent; Papilledema; Ventriculoperitoneal Shunt; Hydrocephalus; Intracranial Hypertension; Diplopia
PubMed: 35181281
DOI: 10.1016/j.survophthal.2022.02.003 -
Survey of Ophthalmology 2021A 13-year-old boy reported acute horizontal binocular diplopia and headache. Ten days before these symptoms he suffered from a gastrointestinal infection....
A 13-year-old boy reported acute horizontal binocular diplopia and headache. Ten days before these symptoms he suffered from a gastrointestinal infection. Ophthalmological examination revealed bilateral ophthalmoparesis and diffuse hyporeflexia. Magnetic resonance imaging of the brain was normal. Lumbar puncture revealed albumin-cytological dissociation. There were no anti-GQ1b antibodies, but serum anti-GM1 antibodies were detected. He received intravenous immunoglobulins and had fully recovered two weeks later. Miller Fisher syndrome and its atypical variants are uncommon in childhood; nevertheless, they should be considered in the differential diagnosis of bilateral acute ophthalmoparesis.
Topics: Adolescent; Autoantibodies; Diplopia; Headache; Humans; Magnetic Resonance Imaging; Male; Miller Fisher Syndrome; Ophthalmoplegia
PubMed: 33010288
DOI: 10.1016/j.survophthal.2020.09.007 -
Seminars in Ophthalmology 2018Diplopia is a disappointing and, at times, unanticipated consequence of what might otherwise be considered anatomically successful strabismus surgery. In this study, we... (Review)
Review
Diplopia is a disappointing and, at times, unanticipated consequence of what might otherwise be considered anatomically successful strabismus surgery. In this study, we review the existing literature regarding diplopia after strabismus surgery in the context of the senior author's experience. We divide postoperative diplopia types into cases that occur in the setting of normal binocular vision (or "normal" suppression) vs. cases that are the consequence of rare or anomalous sensorial adaptations. We then discuss how to identify patients at greatest risk based on history and preoperative testing, and we offer strategies for managing these sometimes-challenging cases.
Topics: Diplopia; Humans; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Postoperative Complications; Prognosis; Strabismus; Vision, Binocular
PubMed: 29193991
DOI: 10.1080/08820538.2017.1353827 -
Seminars in Ophthalmology 2018Diplopia after cataract extraction is an unexpected outcome for the patient and often a source of confusion for the physician, owing to its relative infrequency. This... (Review)
Review
Diplopia after cataract extraction is an unexpected outcome for the patient and often a source of confusion for the physician, owing to its relative infrequency. This article reviews the pertinent literature on the subject. Mechanisms include anesthetic myotoxicity, surgical trauma, optical aberrations, cortical disorders in patients with congenital strabismus, and the unmasking of previously unnoticed ocular misalignment. As the population continues to age and cataract extraction is performed in increasing volume, familiarity with this uncommon but important outcome may help to clarify and effectively treat post-cataract-extraction diplopia.
Topics: Cataract Extraction; Diplopia; Humans; Oculomotor Muscles; Postoperative Complications
PubMed: 28990829
DOI: 10.1080/08820538.2017.1353806 -
Journal of Neuro-ophthalmology : the... Jun 2016
Topics: Aged; Diplopia; Fixation, Ocular; Humans; Male; Strabismus
PubMed: 27176555
DOI: 10.1097/WNO.0000000000000381 -
Current Opinion in Ophthalmology Sep 2018As the population ages, the number of patients presenting to ophthalmologists with complaints of double vision is increasing. (Review)
Review
PURPOSE OF REVIEW
As the population ages, the number of patients presenting to ophthalmologists with complaints of double vision is increasing.
RECENT FINDINGS
Diplopia is known to occur for optical, neuroophthalmological, strabismological and even iatrogenic reasons following various ophthalmic surgical procedures. The mainstays of the nonsurgical treatment of diplopia including no treatment, partial or total occlusion, press-on or ground in prisms and vergence exercises (to increase fusional vergence amplitudes) have been utilized for some time. Although a review of the literature demonstrates that very little has been published on this topic in recent years, subtle treatment variations have evolved.
SUMMARY
The ability to successfully manage patients' diplopia symptoms remains important to decrease the risk of patient injuries, as well as maximize their independence and quality of life. These concerns are especially important as patients age.
Topics: Diplopia; Disease Management; Humans; Vision, Binocular
PubMed: 30096086
DOI: 10.1097/ICU.0000000000000513 -
Journal of Pediatric Ophthalmology and... Sep 2020
Topics: Diplopia; Disease Management; Eyeglasses; Humans; Vision, Binocular
PubMed: 32956474
DOI: 10.3928/01913913-20200501-01 -
Neurology India 2022Diplopia, or double vision, is a symptom resulting from the perception of two images of a single object. We report a case of a possible silodosin-induced diplopia never...
Diplopia, or double vision, is a symptom resulting from the perception of two images of a single object. We report a case of a possible silodosin-induced diplopia never reported before in the literature. We suggest that binocular diplopia should be considered in people assuming silodosin even if further studies should be conducted to explore possible pathogenetic mechanisms.
Topics: Diplopia; Humans; Indoles; Vision, Binocular
PubMed: 35864693
DOI: 10.4103/0028-3886.349650 -
Seminars in Ophthalmology Jul 2024Dragged-fovea diplopia syndrome (DFDS) is a type of binocular double vision caused by a displacement of the fovea in one or both eyes due to retinal disorders including... (Review)
Review
Dragged-fovea diplopia syndrome (DFDS) is a type of binocular double vision caused by a displacement of the fovea in one or both eyes due to retinal disorders including epiretinal membranes or other maculopathies. DFDS induces diplopia through a mismatch between peripheral motor fusion and central (foveal) fusion. It can be diagnosed by utilizing the Lights on - Lights off test. While there is no cure, there are treatments for DFDS including monocular occlusion or blurring (tape, lenses, IOL), Bangerter filter, and Fresnel prisms. While this syndrome has been identified in the literature by multiple names including central-peripheral Rivalry (CPR)-type diplopia, macular diplopia, and foveal displacement syndrome, this article works to summarize the current known characteristics, diagnostic tests, and treatment for this syndrome.
Topics: Humans; Diplopia; Syndrome; Fovea Centralis; Vision, Binocular; Visual Acuity; Tomography, Optical Coherence; Retinal Diseases
PubMed: 38591258
DOI: 10.1080/08820538.2024.2323121