Skip to main content
  • 905 Accesses

Abstract

Double vision is a common neuro-ophthalmic symptom for which the underlying etiology can vary from simple to emergency. Determining the diagnosis can be straightforward to challenging. This chapter provides an overview of the approach to the patient with double vision from the perspective of an internist, and we will cover common and some less common diagnoses which will be in the differential diagnosis for the neuro-ophthalmologist. Anatomic locations for the pathologies of diplopia can span the anterior surface of the eye to the occipital cortex. In the past binocular diplopia (i.e. strabismus) was described as underaction or overaction of the extraocular muscles, however our understanding of the mechanisms of action are emerging that go beyond this description. For details on the neuroanatomical pathways that may cause double vision, primary source and review articles are referenced at the end of this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Suggested Reading

  • Evaluation and management of diplopia – clinical education focal point excerpt. Am Acad Ophthalmol. https://www.aao.org/focalpointssnippetdetail.aspx?id=8eb21322-ab3c-49f9-a772-b9ba8bd9783f.

  • Horn AKE, Adamczyk C. Chapter 9 – Reticular formation: eye movements, gaze and blinks. In: The human nervous system, vol. 3. 3rd ed. Amsterdam: Elsevier Academic Press; 2012.

    Google Scholar 

  • Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009;40(11):3504–10.

    Google Scholar 

  • Kattah JC. Update on HINTS Plus, with discussion of pitfalls and pearls. J Neurol Phys Ther. 2019;43(2):S42–5.

    Article  Google Scholar 

  • Krauzlis RJ. Chapter 32: Eye movements. In: Fundamental neuroscience. 4th ed. Amsterdam: Elsevier/Academic Press; 2013.

    Google Scholar 

  • Leigh RJ, Zee DS. The neurology of eye movements, Contemporary neurology series. 5th ed. New York: Oxford University Press; 2015. (HIGHLY RECOMMENDED REFERENCE GUIDE).

    Google Scholar 

  • Purvin VA, Kawasaki A. Common neuro-ophthalmic pitfalls: case-based teaching. Cambridge: Cambridge University Press; 2009. (HIGHLY RECOMMENDED).

    Book  Google Scholar 

  • Rutar T, Demer JL. “Heavy Eye” syndrome in the absence of high myopia: a connective tissue degeneration in elderly strabismic patients. J AAPOS. 2009;13(1):36–44.

    Article  Google Scholar 

  • Schoser BG. Ocular myositis: diagnostic assessment, differential diagnoses, and therapy of a rare muscle disease – five new cases and review. Clin Ophthalmol. 2007;1(1):37–42.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Linus D. Sun MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sun, L.D. (2019). Diplopia. In: Casper, D., Cioffi, G. (eds) The Columbia Guide to Basic Elements of Eye Care. Springer, Cham. https://doi.org/10.1007/978-3-030-10886-1_37

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-10886-1_37

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10885-4

  • Online ISBN: 978-3-030-10886-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics