Diplopia

Diplopia is commonly described as the simultaneous perception of two images of a single object or seeing double

A common complaint in both inpatient and outpatient neurological practice De Lott LB et al have shown in a study that almost 805000 ambulatory and 50000 emergency room visits in the US yearly where the main complaint was diplopia

Underlying cause can be both neurological and ophthalmological The causes can studied based on if the diplopia is monocular or binocular

Monocular diplopia - If the symptom persist with one eye closed - it is monocular The causes of monocular diplopia are usually ophthalmological with refractive error being the most common Causes of include- cataract- corneal shape problems like keratoconus- astigmatism- corneal scarring- dislocated lens- dry eyes- poorly centered intraocular lenses- severe structural retinal pathology- macular disease Primary or secondary visual cortex disorder ( usually bilateral monocular diplopia )

This happens due to misalignment of the eyes / visual axis and must be considered neurological in origin Binocular diplopia resolves when one eye is closed Causes of binocular diplopia includesCranial -isolated cranial nerve 3rd , 4th , 6th palsycombined cranial neuropathyNeuromuscular ( myasthenia gravis , botulism )Oribital infiltration - e.g thyroid infiltrative ophthalmology...