Materiały źródłowe

• #1 Diplopia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441905/

  Diplopia is a visual disturbance characterized by the perception of double images. Diplopia arises from diverse origins, either due to ocular misalignment resulting in binocular vision disruption or from optical anomalies leading to monocular diplopia, which persists even with one eye closed. […] Binocular diplopia occurs because the image falls outside of the fovea in 1 eye, thus triggering the perception of 2 separate images. If eye misalignment is horizontal, diplopia is horizontal; if the eye misalignment is vertical, diplopia will be vertical. […] The etiology of diplopia is either eye misalignment (if diplopia is binocular) or an optical phenomenon (if diplopia is monocular). Eye misalignment can have numerous causes; to understand it, it is important to follow the anatomical algorithm of eye alignment. Specifically, both eyes need to receive equal innervation of all extraocular muscles to be in the primary position when the innervation to antagonist extraocular muscles in each eye is equal. Any lesion that affects the muscles and nerves up to the cranial nerve nuclei and their tracts can cause double vision.

• #1 Double vision (Diplopia): Causes, treatments, and more

  https://www.medicalnewstoday.com/articles/170634

  Double vision occurs when a person sees a double image where there should only be one. The two images can be side by side, on top of one another, or both. It can happen for many reasons, including diabetes and a blow to the head. […] Binocular double vision only occurs when both eyes are open. If a person closes one eye, the double vision will go away, as it is caused by each eye seeing slightly differently. […] Monocular double vision may occur when the double vision results from an issue with just one eye. […] Treatment of double vision depends on the cause and type. Treatments can include eye exercises, specially designed glasses, and surgery. […] Diplopia can affect one or both eyes. In monocular diplopia, the double image persists even if the other eye is closed. The cause for this is often in the eye and unlikely because of a neurological problem.

• #1 Diplopia (Double Vision) – Understanding a Complex Visual Disorder

  https://doctency.com/diplopia-double-vision/

  Diplopia, commonly known as double vision, is a condition where a person perceives two images of a single object. […] The pathophysiology of diplopia involves several mechanisms: […] Disruption of Eye Alignment: When the eyes do not align properly due to muscle weakness or neurological issues, the brain receives mismatched signals from each eye. […] Neurological Dysfunction: Conditions affecting cranial nerves that control eye movements can lead to misalignment and subsequent double vision. […] Understanding these mechanisms helps inform treatment strategies aimed at restoring proper eye alignment and function.

• #1 Diplopia – Wikipedia

  https://en.wikipedia.org/wiki/Diplopia

  The brain calculates the visual direction of an object based upon the position of its image relative to the fovea. […] Thus, when the eyes are misaligned, the brain perceives two images of one target object, as the target object simultaneously stimulates different, noncorresponding, retinal areas in either eye, thus producing double vision. […] This correlation of particular areas of the retina in one eye with the same areas in the other is known as retinal correspondence. […] The brain naturally guards against double vision. […] The ability to suppress is to be found particularly in childhood when the brain is still developing. […] In some cases, diplopia disappears without medical intervention, but in other cases, the cause of the double vision may still be present. […] Temporary binocular diplopia can be caused by alcohol intoxication or head injuries, such as concussion. […] The appropriate treatment for binocular diplopia depends upon the cause of the condition producing the symptoms. […] Treatment options include eye exercises, wearing an eye patch on alternative eyes, prism correction, and in more extreme situations, surgery or botulinum toxin.

• #1 Diplopia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK441905/

  Binocular diplopia occurs because the image falls outside of the fovea in 1 eye, thus triggering the perception of 2 separate images. If eye misalignment is horizontal, diplopia is horizontal; if the eye misalignment is vertical, diplopia will be vertical. […] Common cases of diplopia in adults are outpatient and can be classified based on their type of strabismus, which share typical age ranges and features. Although diplopia in adults is typically idiopathic, diplopia can be an indication of a serious pathological cause. […] The prognosis of diplopia is very variable and depends entirely on the underlying condition that is causing it. Benign cases may be chronic and will need surgical correction. Diplopia may be corrected in cases where the underlying condition is treated, as in most cases of myasthenia gravis and Guillain-Barr variants. Lesions in the brainstem (small strokes) may improve over time.

• #1 Diplopia (Double Vision): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1214490-overview

  Binocular diplopia (or true diplopia) is a breakdown in the fusional capacity of the binocular system. The normal neuromuscular coordination cannot maintain correspondence of the visual objects on the foveae of the two eyes. Rarely, fusion cannot occur because of dissimilar image size, which can occur after changes in the optical function of the eye after refractive surgery (eg, LASIK) or after a cataract is replaced by an intraocular lens or because of aniseikonia, which represents a discrepancy in image size perceived by the two eyes. […] Monocular diplopia may result from abnormal light transmission to the retina (eg, corneal distortion or scarring, multiple openings in the iris, cataract or subluxation of the natural lens or pseudophakic lens implant, vitreous abnormalities, retinal conditions). Monocular diplopia must be distinguished from metamorphopsia, in which objects appear misshapen.

• #1 Top Causes of Double Vision

  https://www.reviewofoptometry.com/article/top-causes-of-double-vision

  A patient presenting with diplopiawhether horizontal, vertical or diagonalis often a clinical challenge. […] Most etiologies will fall into one of five categories: (1) refractive, (2) binocular vision disorder, (3) orbital disease, (4) neuromuscular junction dysfunction, or (5) injury to the central nervous system/cranial nerves (CNs). […] A thorough systemic health history and step-by-step examination is key to localizing most underlying etiologies. […] Certain medications can cause binocular diplopia, such as anticonvulsants, selective serotonin reuptake inhibitor antidepressants, erectile dysfunction medications, migraine therapies and other medications with anticholinergic properties. […] Horizontal diplopia, when the images are truly side-by-side, is suggestive of a medial or lateral rectus under action or restriction.

• #1 Double vision (Diplopia): Causes, treatments, and more

  https://www.medicalnewstoday.com/articles/170634

  A common cause of binocular double vision is a squint or strabismus. […] Strabismus causes the eyes to look in slightly different directions. […] This condition might be because the affected eye has the following difficulties: they are paralyzed or weak; they have restricted movement; they are too strong or overactive; the nerves controlling the eye muscles have abnormalities. […] Other conditions that can cause double vision include: Thyroid dysfunction, Stroke or transient ischemic attack, Aneurysm, Convergence insufficiency, Diabetes, Myasthenia gravis, Brain tumors and cancers, Multiple sclerosis (MS), Black eye, Head injury. […] If double vision is noted when one eye is covered but not the other, this is referred to by eye specialists as monocular double vision. […] Treatment varies depending on what is causing monocular double vision, including: Astigmatism, Laser surgery, Cataracts, Dry eye.

• #1 Top Causes of Double Vision

  https://www.reviewofoptometry.com/article/top-causes-of-double-vision

  Differential diagnosis for horizontal diplopia at distance includes unilateral or bilateral CN VI palsy, internuclear ophthalmoplegia (INO), age-related decompensating esophoria or muscle restriction, most commonly from thyroid disease, a space occupying lesion or myasthenia gravis (MG). […] Some diseases may cause variable patterns of horizontal, vertical and oblique diplopia throughout the day. […] A patient with GCA can present with any CN palsy. […] MG is the classic neuromuscular junction disease that can become life threatening when it affects the muscles of respiration, causing respiratory failure. […] Approximately 50% to 60% of MG patients present with a ptosis and diplopia, and approximately 20% to 30% have localized ocular involvement. […] A CN IV palsy affects the function of the superior oblique muscle, resulting in a vertical oblique diplopia more noticeable in downgaze.

• #1 Causes of Double Vision | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/eyes-and-vision/double-vision/causes.html

  A range of conditions can cause double vision, including problems within the eye, such as the cornea or lens. Other underlying causes can involve muscles or nerves controlling eye function and movement, or issues in the brain. Some causes can be minor, such as astigmatism, or life threatening, such as an aneurysm or stroke. […] Problems in the cornea distort its surface, which can create double vision. […] The most common lens problem that can cause double vision is a cataract, a clouding of the normally clear lens due to aging. […] Problems in these extraocular muscles include weakness or paralysis that prevent one eye from moving in coordination with the other. […] Some conditions that can affect or damage these cranial nerves and lead to double vision include: Diabetes, a metabolic disease affecting your body’s ability to process blood sugar that can cause nerve damage; Guillain-Barre syndrome, a nerve condition in which early symptoms can occur in the eyes, causing muscle weakness; Myasthenia gravis, an autoimmune disease in which the immune system attacks neuromuscular junctions involved in eye movement; Multiple sclerosis, a chronic neurological disease affecting the central nervous system, possibly damaging nerves that control eye movement. […] If these areas are affected by illness or injury, double vision can result. […] When these vessels, which are responsible for eye nourishment, encounter reduced blood flow a condition known as anterior ischemic optic neuropathy can develop.

• #1 Diplopia: Suddenly Seeing Double, Causes, Correction

  https://www.verywellhealth.com/diplopia-8622686

  Brain issues: It’s up to the brain to decipher the visual images that come from the eyes. Conditions such as migraine headaches, tumors, aneurysms (outpouchings of blood vessels), strokes, infections, or head trauma can possibly be the cause. […] The most common cause of diplopia usually depends on age. When a person over 65 complains of monocular diplopia, the usual diagnosis is cataracts or dry eyes. When that same person complains of binocular diplopia, the cause may be cranial nerve palsy due to diabetes or hypertension. […] Double vision can occur in one or both eyes. It may be caused by something in the eye itself, by the muscles or nerves involved, or even by the brain. While having double vision does not usually mean anything is seriously wrong, particularly if it comes on suddenly, it is important to promptly get it checked.

• #1 Double Vision (Diplopia) – Harvard Health

  https://www.health.harvard.edu/a_to_z/double-vision-diplopia-a-to-z

  Damage to nerves controlling the extraocular muscles. Nerves can be injured by brain damage caused by infection, multiple sclerosis, stroke, head trauma or a brain tumor, especially a tumor located at the lower back portion of the brain. […] Diabetes. This disease can lead to problems with the nerves that control eye muscle movements. Sometimes this can happen before the person is aware that he or she has diabetes. […] Myasthenia gravis. This is a neuromuscular illness that causes the body’s muscles to tire easily and become weak. It occurs because the body’s immune system mistakenly attacks the places where nerves transmit impulses to muscles, telling the muscles to contract. […] Graves’ disease. This is the most common cause of an overactive thyroid (hyperthyroidism). Some people with Graves’ disease develop double vision due to swelling and thickening of the muscles that move the eyes within the eye socket. […] Trauma to the eye muscles. The muscles of the eye socket can be injured by facial trauma, especially by a fracture of the thin bones of the eye socket.

• #1 Causes of Double Vision and How to Address Them – Assil Gaur Eye Institute Blog

  https://assileye.com/blog/?p=4023

  In some cases, strabismus develops in childhood. It can also appear later in life as a result of a chronic condition that affects muscle control or nerve sensitivity. […] In addition, some types of head injury (especially near the eye socket) can also damage the eye muscles or lead to cranial nerve palsy which, in turn, may cause diplopia. […] Treatments for double vision will depend on its root cause, and some fall outside the realm of ophthalmology. […] Meanwhile, people with binocular diplopia can also find relief from an eye patch, as this will make the ghost image disappear.

• #1 Double Vision – Saratoga Ophthalmology

  https://saratoga-ophthalmology.com/double-vision/

  Double vision can also occur due to skew deviation, which is vertical misalignment of the eyes that does not map out to any cranial nerve. This is thought to be caused by a pathology in midbrain. […] Double vision can occur with orbital process as well. Thyroid eye disease and idiopathic orbital inflammation can both affect the eye muscles to cause double vision. […] Finally, decompensating congenital strabismus (lazy eye) can cause double vision. […] One of the most common causes of double vision is microvascular cranial neuropathy, usually seen in people with long standing diabetes or hypertension. […] After the causes of double vision are investigated, your doctor might be able to predict approximately how long the double vision may last. […] For most people, even in cases where the specific cause is not found, the treatment is focused on lessening the symptom of double vision. […] If these are very effective, permanent prism can be ground into the lenses of the eyeglasses.

• #1 Diplopia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441905/

  A study in South China used a new classification system for assessing diplopia according to extraocular muscle (EOM) dysfunction. […] Monocular diplopia is almost always an ophthalmological problem and stems from the cataractous changes in the crystalline lens, abnormalities in the corneal surface (keratoconus or uncorrected astigmatism), and, exceedingly rarely, lesions affecting the occipital cortex (termed „cortical polyopia”), in which case they are almost always accompanied by homonymous visual field defects. […] Another review identified the common cause of binocular diplopia according to etiologic distribution and clinical features such as microvascular, strokes, neoplastic, myasthenia gravis, and traumatic and decompensated phoria. […] The prognosis of diplopia is very variable and depends entirely on the underlying condition that is causing it. Benign cases may be chronic and will need surgical correction. Diplopia may be corrected in cases where the underlying condition is treated, as in most cases of myasthenia gravis and Guillain-Barr variants. Lesions in the brainstem (small strokes) may improve over time.

• #1 Double vision

  https://www.nhs.uk/conditions/double-vision/

  Double vision has many possible causes, depending on whether 1 eye or both eyes are affected. […] Double vision affecting both eyes is usually a symptom of a squint. […] This is where problems with the eye muscles or nerves cause the eyes to look in slightly different directions. […] Squints or binocular double vision in adults can be a sign of a more serious condition. […] Double vision affecting 1 eye is less common. […] It’s usually caused by eye problems such as: dry eyes where the eyes do not produce enough tears, astigmatism a common condition where part of the eye is not a perfect shape, cataracts cloudy patches over the front of the eyes, keratoconus where the clear outer layer of the eye (cornea) gets thinner and changes shape.

• #1 What Causes Double Vision? | The Binetter Eye Centre

  https://binettereyecentre.com.au/2019/09/20/what-causes-double-vision/

  Astigmatism. This is a condition where the front surface of the cornea is abnormally curved hence causing double vision. […] Keratoconus is a degenerative condition that causes the cornea to gradually become cone-shaped and thin. […] Pterygium. This is thickening and hardening of the conjunctiva causing it to extend to the cornea and cause double vision. […] Retinal abnormalities. For example, in macular degeneration, the centre of the field of vision gradually disappears, and if there’s swelling, double vision can occur in one eye. […] Cataracts in the eyes can also cause diplopia in one eye. […] Treatment for double vision usually depends on the underlying condition(s) that caused it. […] For people experiencing binocular diplopia, the most common treatments include: eye exercises, wearing glasses, wearing opaque contact lenses, wearing an eye patch, vision therapy, medications, and surgery to correct muscle positioning.

• #1 Double Vision (Diplopia): Causes, Definition & Treatments

  https://www.allaboutvision.com/conditions/symptoms/diplopia/double-vision/

  If you have sudden double vision that you ignore and then it goes away over a long time period, this may mean your brain has tuned out one of the images (suppressed it). […] Some conditions causing double vision are difficult, if not impossible, to fix. […] The sudden onset of diplopia could signal a condition that may be a matter of life and death, such as a brain tumor or aneurysm.

• #1 Diplopia – Wikipedia

  https://en.wikipedia.org/wiki/Diplopia

  Diplopia is the simultaneous perception of two images of a single object that may be displaced in relation to each other. […] 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 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. […] Binocular diplopia is double vision arising as a result of strabismus (in layman’s terms „cross-eyed”), the misalignment of the two eyes relative to each other, either esotropia (inward) or exotropia (outward).

• #1 Causes of Sudden and Temporary Double Vision

  https://www.allaboutvision.com/conditions/symptoms/diplopia/sudden-double-vision/

  Double vision, or diplopia, is typically fleeting, it can indicate a serious and possibly life-threatening problem, such as an aneurysm or brain tumor. […] Double vision can occur suddenly and last for different periods of time and to varying degrees of severity for each individual person and occurrence. […] Temporary cases of diplopia are less likely to require serious medical attention than ongoing (longer-lasting) or reoccurring (intermittent or transient) cases. […] Intermittent (or reoccurring) double vision may come and go as a result of one of the following ongoing issues: side effects from certain medications, high blood pressure, previous trauma, migraine headaches, complications of diabetes, eye muscle problems such as strabismus, cornea problems such as dry eye syndrome or astigmatism, lens problems such as cataracts.

• #1 Mayo Clinic Q and A: Double vision can often be effectively treated – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-double-vision-can-often-be-effectively-treated/

  Double vision, also called diplopia, is either monocular or binocular. Monocular double vision is present in each eye separately. Binocular double vision is only present with both eyes open. This distinction is very important because monocular double vision is never dangerous, while binocular double vision can be caused by some serious neurologic conditions. […] Binocular double vision, or binocular diplopia, is caused by misalignment of the eyes. This causes the images from each eye to be off a bit, making you see two images. With this type of double vision, the images often are completely distinct with space between them. […] Conditions that may cause binocular double vision include previous trauma, stroke, systemic disorders and other diseases. If you develop symptoms of binocular diplopia suddenly, seek medical care right away. Some of the causes of binocular double vision can be neurologically dangerous.

• #1 Double vision | The BMJ

  https://www.bmj.com/content/351/bmj.h5385

  Double vision, or diplopia, may be the first sign of life threatening pathology, or it may be completely benign. A rapid and systematic assessment is, therefore, crucial. […] Is the diplopia is monocular or binocular? The latter may indicate a life threatening cause. […] Binocular diplopia occurs with both eyes open and disappears when either eye is covered. […] Are the images separated vertically (on top of each other), or horizontally (side by side)? Vertical diplopia indicates impaired elevation or depression of the eye (such as decompensated squints, thyroid eye disease, fourth nerve palsies).

• #2 Diplopia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK441905/

  Diplopia, or double vision, is the separation of images vertically, horizontally, or obliquely and can be described as monocular or binocular in origin. This condition can be due to either ocular misalignment, which disappears when either eye is occluded, or to an optical problem termed monocular diplopia, which does not disappear with monocular viewing. Binocular diplopia is usually caused by ocular misalignment or strabismus that can be detected using simple clinical tests. […] The etiology of diplopia is either eye misalignment (if diplopia is binocular) or an optical phenomenon (if diplopia is monocular). Eye misalignment can have numerous causes; to understand it, it is important to follow the anatomical algorithm of eye alignment. Specifically, both eyes need to receive equal innervation of all extraocular muscles to be in the primary position when the innervation to antagonist extraocular muscles in each eye is equal. Any lesion that affects the muscles and nerves up to the cranial nerve nuclei and their tracts can cause double vision.

• #2 Diplopia (Double Vision) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/double-vision

  Seeing double can cause considerable concern if you or a loved one experience it. Double vision, which is also called diplopia, causes people to see two of the same imagewhether horizontal, vertical or diagonalinstead of one. […] Sometimes double vision can just be an irritating but benign problem called strabismus. Other times the condition arises from a serious medical condition. […] Two main types of double vision exist: Monocular diplopia occurs when someone sees double vision with only one eye open, a second image usually appearing as a ghost. Causes are typically confined to the eye and less likely to be neurological. […] Binocular diplopia occurs when someone sees double vision only when both eyes are open. Causes may be serious conditions, neurological or otherwise. […] Dozens of medical conditions can lead to double vision.

• #2 Double Vision | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/doublevision/

  Double vision, also known as diplopia, occurs when a single object is seen as two images at the same time. […] Double vision has many causes and is a frequent reason for patients to see an eye doctor or a specialist such as a neurologist or neuro-ophthalmologist. […] Monocular double vision is almost always caused by a problem with the way light is focused by the front of the eye onto the retina. […] This type of double vision is often described as seeing a ghost or shadow image next to the main image. […] Monocular double vision is caused by an eye problem, not a problem in the brain or nerves. […] Binocular double vision is always a symptom of eye misalignment (also known as strabismus). […] There are various causes of eye misalignment, including problems of the eye sockets (orbits), eye muscles, nerves that control the eye muscles (cranial nerves), a problem with communication between the nerves and their eye muscles, or problems with the brain itself.

• #2 Diplopia – Wikipedia

  https://en.wikipedia.org/wiki/Diplopia

  Diplopia is the simultaneous perception of two images of a single object that may be displaced in relation to each other. […] 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 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. […] Binocular diplopia is double vision arising as a result of strabismus (in layman’s terms „cross-eyed”), the misalignment of the two eyes relative to each other, either esotropia (inward) or exotropia (outward).

• #2 Diplopia – Wikipedia

  https://en.wikipedia.org/wiki/Diplopia

  The brain calculates the visual direction of an object based upon the position of its image relative to the fovea. […] Thus, when the eyes are misaligned, the brain perceives two images of one target object, as the target object simultaneously stimulates different, noncorresponding, retinal areas in either eye, thus producing double vision. […] This correlation of particular areas of the retina in one eye with the same areas in the other is known as retinal correspondence. […] The brain naturally guards against double vision. […] The ability to suppress is to be found particularly in childhood when the brain is still developing. […] In some cases, diplopia disappears without medical intervention, but in other cases, the cause of the double vision may still be present. […] Temporary binocular diplopia can be caused by alcohol intoxication or head injuries, such as concussion. […] The appropriate treatment for binocular diplopia depends upon the cause of the condition producing the symptoms. […] Treatment options include eye exercises, wearing an eye patch on alternative eyes, prism correction, and in more extreme situations, surgery or botulinum toxin.

• #2 Double vision | The BMJ

  https://www.bmj.com/content/351/bmj.h5385

  Double vision, or diplopia, may be the first sign of life threatening pathology, or it may be completely benign. A rapid and systematic assessment is, therefore, crucial. […] Is the diplopia is monocular or binocular? The latter may indicate a life threatening cause. […] Binocular diplopia occurs with both eyes open and disappears when either eye is covered. […] Are the images separated vertically (on top of each other), or horizontally (side by side)? Vertical diplopia indicates impaired elevation or depression of the eye (such as decompensated squints, thyroid eye disease, fourth nerve palsies).

• #2 Diplopia (Double Vision): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1214490-overview

  Binocular diplopia (or true diplopia) is a breakdown in the fusional capacity of the binocular system. The normal neuromuscular coordination cannot maintain correspondence of the visual objects on the foveae of the two eyes. Rarely, fusion cannot occur because of dissimilar image size, which can occur after changes in the optical function of the eye after refractive surgery (eg, LASIK) or after a cataract is replaced by an intraocular lens or because of aniseikonia, which represents a discrepancy in image size perceived by the two eyes. […] Monocular diplopia may result from abnormal light transmission to the retina (eg, corneal distortion or scarring, multiple openings in the iris, cataract or subluxation of the natural lens or pseudophakic lens implant, vitreous abnormalities, retinal conditions). Monocular diplopia must be distinguished from metamorphopsia, in which objects appear misshapen.

• #2 Diplopia – WikEM

  https://wikem.org/wiki/Diplopia

  Double vision that resolves when the other eye is closed […] Related to a problem with visual axis alignment […] Eye musculature dysfunction […] Cranial nerve dysfunction […] Brainstem or intracranial process […] Multiple cranial nerve involvement suggests an intracranial process or cavernous sinus involvement […] Sudden painful or non painful onset suggest a vascular cause such as thrombosis, dissection, ischemia, or vasculitis […] Bilateral symptoms are more likely with neuromuscular problems such as Miller Fischer syndrome, botulism, or myasthenia gravis […] Third nerve palsy: eye is down and out […] Fourth nerve palsy: head tilt down and away from side of lesion […] Sixth nerve palsy: eye can’t track laterally […] Treat underlying cause […] Neurology or neurosurgical consult is warranted if evidence of an ICH, aneurysm or CVA.

• #2 Top Causes of Double Vision

  https://www.reviewofoptometry.com/article/top-causes-of-double-vision

  Differential diagnosis for horizontal diplopia at distance includes unilateral or bilateral CN VI palsy, internuclear ophthalmoplegia (INO), age-related decompensating esophoria or muscle restriction, most commonly from thyroid disease, a space occupying lesion or myasthenia gravis (MG). […] Some diseases may cause variable patterns of horizontal, vertical and oblique diplopia throughout the day. […] A patient with GCA can present with any CN palsy. […] MG is the classic neuromuscular junction disease that can become life threatening when it affects the muscles of respiration, causing respiratory failure. […] Approximately 50% to 60% of MG patients present with a ptosis and diplopia, and approximately 20% to 30% have localized ocular involvement. […] A CN IV palsy affects the function of the superior oblique muscle, resulting in a vertical oblique diplopia more noticeable in downgaze.

• #2 Approach to Double Vision in the ED — NUEM Blog

  https://www.nuemblog.com/blog/double-vision

  Double vision, or diplopia, is a relatively infrequent presenting symptom in the emergency setting, representing 0.1% of Emergency Department (ED) complaints. […] Diplopia can result from benign processes, such as dry eyes or idiopathic cranial nerve palsy, to emergent conditions with high morbidity, such as stroke, aneurysm, or inflammatory processes. […] Given the dangerous etiologies at play, clinicians must approach these patients in a systematic and cautious manner. […] In patients presenting with diplopia, the first concern must be the possibility of stroke and the need to consider time-sensitive treatment with thrombolytics. […] Cranial nerves (CN) 3, 4, and 6 are supplied by the vertebrobasilar arterial system and strokes affecting these nerves most often present with cerebellar dysfunction and/or crossed signs or contralateral hemiparesis from involvement of the corticospinal tracts.

• #2 Double vision | Ento Key

  https://entokey.com/double-vision/

  Double vision can be caused by disease of the: […] The most common causes of double vision in adults are the presumed ischemic ocular motor nerve palsies. […] Third, fourth and sixth nerve palsies are potentially the most dangerous causes of double vision because they are often caused by an intracranial aneurysm or brain tumor compressing the nerve. […] A stroke, tumor or degenerative disease within the brain can present with double vision by causing an ocular motor nerve palsy, an internuclear ophthalmoplegia (INO), a skew deviation or a supranuclear palsy. […] Myasthenia is one of the great mimickers causing diplopia and can simulate a fourth, sixth or pupil-sparing third nerve palsy. […] Autoantibodies directed against the acetylcholine receptors are produced, circulate in the blood and destroy or block many of the receptors. […] The decreased number of functioning acetylcholine receptors results in the fatigability that is so often seen clinically: on repeated or sustained contraction, fewer receptors are available for activation and the strength of the muscle fades.

• #2 Approach to Double Vision in the ED — NUEM Blog

  https://www.nuemblog.com/blog/double-vision

  If a patient has fevers, facial infections, or meningismus one must consider orbital cellulitis, cavernous venous sinus thrombosis (CVST), meningitis, or encephalitis. […] If a patient has proptosis, chemosis, headaches, and/or facial sensory changes, consider cavernous sinus pathology such as CCF, aneurysm, CVST, mass, or Tolosa-Hunt syndrome (idiopathic inflammatory changes within the cavernous sinus). […] Lastly, if patients have concomitant vision changes/loss, consider pathology of the orbital apex such as mass, infection, and thyroid eye disease. […] In patients with internuclear ophthalmoplegia (INO), admission for MR and neurology consultation is appropriate to rule out stroke and MS, the most common causative pathologies. […] GCA is a vision-threatening disease and must be considered in patients over the age of 60 with transient or persistent diplopia as it is a presenting complaint in 6-27% GCA patients.

• #2 What Causes Double Vision? | The Binetter Eye Centre

  https://binettereyecentre.com.au/2019/09/20/what-causes-double-vision/

  Diabetes can lead to various problems with nerves that control the movement of the eye muscles. Some people may experience double vision even before they are aware they have diabetes. […] Graves disease can also cause double vision due to thickening and swelling of the muscles that control the eyeball. […] Myasthenia gravis is a neuromuscular disease that causes muscles to become weak and tire easily. […] Extraocular muscles can be injured or damaged by facial trauma, especially fractures of the bones of the eye socket. […] Strabismus is a condition that causes childhood misalignment of the eyes. It affects about 4 percent of kids younger than age 6 and may cause binocular diplopia. […] This is when double vision occurs in only one eye. This means that the doubling does not go away even when you cover the other eye or look in different directions.

• #2 Double Vision (Diplopia) – Harvard Health

  https://www.health.harvard.edu/a_to_z/double-vision-diplopia-a-to-z

  Damage to nerves controlling the extraocular muscles. Nerves can be injured by brain damage caused by infection, multiple sclerosis, stroke, head trauma or a brain tumor, especially a tumor located at the lower back portion of the brain. […] Diabetes. This disease can lead to problems with the nerves that control eye muscle movements. Sometimes this can happen before the person is aware that he or she has diabetes. […] Myasthenia gravis. This is a neuromuscular illness that causes the body’s muscles to tire easily and become weak. It occurs because the body’s immune system mistakenly attacks the places where nerves transmit impulses to muscles, telling the muscles to contract. […] Graves’ disease. This is the most common cause of an overactive thyroid (hyperthyroidism). Some people with Graves’ disease develop double vision due to swelling and thickening of the muscles that move the eyes within the eye socket. […] Trauma to the eye muscles. The muscles of the eye socket can be injured by facial trauma, especially by a fracture of the thin bones of the eye socket.

• #2 Diplopia – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/symptoms-of-ophthalmic-disorders/diplopia

  Diplopia is the perception of 2 images of a single object. […] Binocular diplopia suggests disconjugate alignment of the eyes. […] Most commonly, the eyes are misaligned because of a disorder affecting the cranial nerves innervating the extraocular muscles (third, fourth, or sixth cranial nerves). […] Whether pain is present depends on the disorder. […] Other causes involve mechanical interference with ocular motion (which often cause pain) or a generalized disorder of neuromuscular transmission (which typically do not cause pain). […] Intermittent diplopia suggests a waxing and waning neurologic disorder, such as myasthenia gravis or multiple sclerosis, or unmasking of a latent phoria (eye deviation). […] Pain suggests a compressive lesion or inflammatory disorder. […] Treatment is management of the underlying disorder.

• #2 Diplopia (Double Vision): Monocular and Binocular Causes and Treatment

  https://www.healthline.com/health/diplopia

  Diplopia causes you to see two images of one object. This condition is commonly called double vision. Typically, this vision problem is the result of an underlying condition. Identifying and treating the cause can help you recover your eyesight and stop other symptoms from occurring. […] A problem within your brain or the nerves to your eyes may be the cause of binocular diplopia. Once your doctor identifies which type of double vision you have, they can start looking for the cause. […] Binocular diplopia will disappear if you shield one eye. Double vision occurs because the two eyes are not working together. […] Any inflammation or injury to the nerves can cause double vision. […] This immune condition affects communication between nerves and muscles throughout your body. In the eyes, this can cause rapid fatigue. This weakness of the eye muscles can lead to double vision.

• #2 Double Vision Treatment

  https://www.richmondeye.com/eyehealth_double

  Double vision can occur due to swelling and dysfunction of the eye muscles. […] Double vision can occur due to distortion of images passing through the lens of the eye, and from glare. […] An uncorrected glass prescription, especially if nearsighted or with astigmatism, can lead to ghost images or slight double vision. […] Certain types of cataract can lead to double vision due to distortion of images passing through the lens of the eye, and from glare.

• #2 What is double vision (Diplopia)?

  https://www.seevividly.com/info/Binocular_Vision/Signs_and_Symptoms/Double_Vision

  One of the main causes of double vision is Strabismus, or when the eyes are not properly aligned together, usually do to a physiological problem. […] Interestingly, when double vision occurs because of a persistent condition like strabismus, the brain may automatically adapt by shutting down or ignoring the information from one eye, in order to have less confusing visual information. […] Depending on the cause, double vision may go away on its own, or may require medical intervention and treatment. […] Persistent double vision that is left untreated, but then goes away, may be a sign that your brain has adapted by suppressing the image from one of your eyes (Amblyopia). […] The most effective treatments for Strabismus are surgery to correct the eyes misalignment, and then vision therapy to unsuppress the visual information from the eye the brain decided to turn off. […] Unfortunately, some causes of double vision are irreversible, like stroke, nerve palsy, tumors or other brain injury. […] When you see your doctor, be prepared to answer questions about the context surrounding the first onset of symptoms.

• #2 Double vision (Diplopia): Causes, treatments, and more

  https://www.medicalnewstoday.com/articles/170634

  Depending on the cause, the treatment for binocular vision varies. Treatments include wearing glasses, eye exercises, wearing an opaque contact lens, wearing an eye patch, surgery on the muscles of the eye to correct their positioning. […] In certain types of diplopia, botulinum toxin (Botox) may be injected into the eye muscles, causing them to remain relaxed. […] Exercises cannot treat many of the conditions that cause double vision. However, some exercises can help with convergence insufficiency. […] Vision therapy is a visual program prescribed by optometrists. It includes eye exercises that aim to develop or improve a person’s visual skills. […] A person who experiences a sudden onset of double vision should contact their healthcare professional. […] Neuro-ophthalmologists state that the sudden onset of double vision is one of the three red-flag symptoms that indicate a person may require assessment by a neuro-ophthalmologist. […] Diplopia is an eye condition that can occur due to various causes. It may be temporary, but it can also signal a more serious condition.

• #2 Diplopia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK441905/

  Binocular diplopia occurs because the image falls outside of the fovea in 1 eye, thus triggering the perception of 2 separate images. If eye misalignment is horizontal, diplopia is horizontal; if the eye misalignment is vertical, diplopia will be vertical. […] Common cases of diplopia in adults are outpatient and can be classified based on their type of strabismus, which share typical age ranges and features. Although diplopia in adults is typically idiopathic, diplopia can be an indication of a serious pathological cause. […] The prognosis of diplopia is very variable and depends entirely on the underlying condition that is causing it. Benign cases may be chronic and will need surgical correction. Diplopia may be corrected in cases where the underlying condition is treated, as in most cases of myasthenia gravis and Guillain-Barr variants. Lesions in the brainstem (small strokes) may improve over time.

• #2 Double vision – ProQuest

  https://www.proquest.com/scholarly-journals/double-vision/docview/1777830066/se-2

  Binocular diplopia may indicate a life threatening condition, and a stepwise approach is needed to distinguish this sort of diplopia from benign monocular diplopia […] Double vision, or diplopia, may be the first sign of life threatening pathology, or it may be completely benign. A rapid and systematic assessment is, therefore, crucial. […] Is the diplopia is monocular or binocular? The latter may indicate a life threatening cause […] Vertical diplopia indicates impaired elevation or depression of the eye (such as decompensated squints, thyroid eye disease, fourth nerve palsies (figure ), orbital trauma), whereas horizontal diplopia suggests impaired adduction or abduction of the eye (such as decompensated squints, sixth nerve palsies (figure ), multiple sclerosis.

• #3 Diplopia – Wikipedia

  https://en.wikipedia.org/wiki/Diplopia

  The brain calculates the visual direction of an object based upon the position of its image relative to the fovea. […] Thus, when the eyes are misaligned, the brain perceives two images of one target object, as the target object simultaneously stimulates different, noncorresponding, retinal areas in either eye, thus producing double vision. […] This correlation of particular areas of the retina in one eye with the same areas in the other is known as retinal correspondence. […] The brain naturally guards against double vision. […] The ability to suppress is to be found particularly in childhood when the brain is still developing. […] In some cases, diplopia disappears without medical intervention, but in other cases, the cause of the double vision may still be present. […] Temporary binocular diplopia can be caused by alcohol intoxication or head injuries, such as concussion. […] The appropriate treatment for binocular diplopia depends upon the cause of the condition producing the symptoms. […] Treatment options include eye exercises, wearing an eye patch on alternative eyes, prism correction, and in more extreme situations, surgery or botulinum toxin.

• #3 Double vision | Ento Key

  https://entokey.com/double-vision/

  Double vision can be caused by disease of the: […] The most common causes of double vision in adults are the presumed ischemic ocular motor nerve palsies. […] Third, fourth and sixth nerve palsies are potentially the most dangerous causes of double vision because they are often caused by an intracranial aneurysm or brain tumor compressing the nerve. […] A stroke, tumor or degenerative disease within the brain can present with double vision by causing an ocular motor nerve palsy, an internuclear ophthalmoplegia (INO), a skew deviation or a supranuclear palsy. […] Myasthenia is one of the great mimickers causing diplopia and can simulate a fourth, sixth or pupil-sparing third nerve palsy. […] Autoantibodies directed against the acetylcholine receptors are produced, circulate in the blood and destroy or block many of the receptors. […] The decreased number of functioning acetylcholine receptors results in the fatigability that is so often seen clinically: on repeated or sustained contraction, fewer receptors are available for activation and the strength of the muscle fades.

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