For the most part, patients with monocular diplopia do not warrant a neurologic evaluation since a careful ophthalmic evaluation will reveal the cause (see Table . 4 days ago Objective: To present a report of the ocular motility disorders, treatment and outcomes of myasthenia gravis (MG). Material and method: A. Monocular diplopia is double vision in one eye only, and is much less common than binocular diplopia. A diplopia 1 monocular pode ser causada, entre outras.

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The inferior rectus is the EOM most commonly affected, and patients may complain of vertical double vision unless they adopt a chin-up face position. Ophthalmoparesis Chronic progressive external ophthalmoplegia Kearns—Sayre syndrome.

Evaluation and Management

Variability of diplopia by history or of measurements between examinations is suggestive of MG. Raised intracranial pressure can cause sixth nerve palsy presumably from mechanical stretching of the nerve; thus, many cases may actually have bilateral, but asymmetric, sixth nerve palsy. Demyelination often diplopiia INO in younger adults and microvascular infarction typically causes INO in elderly patients.

Note the slowed saccades of the left eye compared to those cauxas the right. Binocular Diplopia The evaluation of binocular diplopia begins with examining the saccades and pursuit of the eyes individually ductions and together versions. There is upbeat nystagmus in upgaze. Thus, when the eyes are misaligned, the brain will perceive two images of one target object, as the target object simultaneously stimulates different, non-corresponding, retinal areas in dlplopia eye, thus producing double vision.

A partial third ve nerve palsy would typically involve the superior, inferior and medial recti to some degree causing diplopia. Using four easily available equipment an occluder, a pinhole, a direct ophthalmoscope and a target, the causes of monocular diplopia can be.


This presumptive diagnosis depends upon the presence of patient characteristics including older age, vasculopathic risk factors hypertension, diabetes mellitus, or hyperlipidemiaand spontaneous recovery.

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In other cases, aniseikonia from anisometropia leads to disparate-sized images from each eye and the perception of diplopia.

Investigations The patient underwent blood tests, with normal full blood count, urea and electrolytes, liver function tests, thyroid function tests, glucose, lipids, C reactive protein and erythrocyte sedimentation rate.

Monocular Diplopia | holidays |

Some patients may have relative pupil sparing where the affected pupil is larger 0. Diplopiacommonly known as double visionis the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, diagonally i. Hemianopsia binasal bitemporal homonymous Quadrantanopia. The deviation either resolves within the next several days to weeks or evolves into a permanent restrictive strabismus.

In decreasing order of frequency, the medial, superior, and lateral recti may also be affected. If diplopia persists, then this is a negative test Figure 6.

Diplopia monocular causas pdf

Oral steroids are the mainstay of treatment. Also, all lenses have some degree of prismatic power with eccentric viewing from the optical center proportional to the power of the lens. A patient younger than 50 with an isolated mononeuropathy should undergo neuroimaging, preferably magnetic resonance imaging MRI of the brain and orbits with fat suppression and gadolinium administration.


Long-standing, stable misalignment may warrant surgery in patients intolerant of prisms. Published online Jan 5. Diplopia can also occur when viewing with only one eye; this is called monocular diplopiaor, where the patient perceives more than two images, monocular polyopia. Most patients have a visible maculopathy, but others may simply note metamorphopsia on Amsler grid testing. However, incomplete recovery after 3 months, development of aberrant regeneration, or additional cranial nerve involvement should prompt neuroimaging directed at the cavernous sinus and skull base.

Orbital infection is an important differential of orbital myositis, and patients presenting with more diffuse symptoms and signs are commonly treated with intravenous antibiotics and closely monitored re the diagnosis of idiopathic orbital inflammation is made.

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DIPLOPIA by Elizabeth Daniela Brenes Montero on Prezi

Local anesthetics can cause myotoxicity from diffusion into a muscle or more likely from direct injection. Implant reservoirs result in a bleb that may involve the extraocular muscles; therefore, repositioning the implant may eliminate diplopia.

Monocular diplopia persists after occluding one eye. Unilateral ptosis due to isolated levator myositis. The brain calculates the ccausas direction of an object based upon the position of its image relative to the fovea.

Myasthenia gravis can produce a motility disorder identical to an INO or a one-and- a-half syndrome. Divergence Insufficiency and Paralysis Divergence insufficiency is an ocular motor anomaly characterized by horizontal diplopia in the distance. Extraocular motility demonstrates slowed or impaired adduction.