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.
KeywordsDiplopia Double vision Binocular diplopia Oculomotor pathway lesions Strabismus and eye movement abnormalities Oculomotor nerve palsies Horizontal binocular diplopia Monocular diplopia Anisometropia
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