The authors report a case of a 69 year-old woman who developed persistent vertical deviation and diplopia after extracapsular cataract surgery and had a positive past history of thyroid disease. The authors emphasize the need of for detailed orbit propedeutics in order to rule out restrictive strabismus associated with post-facectomy diplopia. Atualmente, a paciente faz uso de levotiroxina. Pseudofacia em ambos os olhos com lentes intraoculares centradas.
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Diplopia is a vision alteration consisting in the perception of double vision. Therefore, the patient usually goes to the consultation reporting the fact of seeing double. Double vision may be:. Patients suffering from diplopia report having experienced at some point a double vision episode, whether occasionally or continuously through time. Therefore, when experiencing this symptom, it is important to undergo an emergency eye exam.
Strabismus, uncorrected refraction errors, cataracts, retinal diseases and some muscular and neurological alterations are among the causes that may lead to double vision. It requires an urgent examination in order to rule out more serious conditions. Double vision or diplopia may occur at any point in life. Children may suffer from diseases leading to double vision, and, in case of strabismus, when the disease is being consolidated, during acute moments when there is a rapid decompensation, episodes of double vision may occur.
Nevertheless, eye deviations caused by strabismus, especially in young ages, are usually compensated by our brain over time , and double vision is not consolidated. Monocular double vision is usually caused by eye structural causes, and in very few cases it is related to neurological alterations.
Some of its causes may be:. In all these eye structure alteration cases, once the alteration is corrected, double vision disappears. In case of binocular double vision, a neurological alteration or eye muscle problems may be at the root of the problem. Diplopia is a symptom. In consultation, in order to carry out a diagnosis and determine why does the patient see double, we perform a comprehensive eye exam, including:.
A patient should go immediately to an emergency room whenever he or she experiences double vision in order to determine the cause of this symptom. If it is due to a decompensated strabismus, there will be enough time to perform an examination. However, it is important to rule out any neurological cause requiring urgent performing of studies and even hospital admissions in order to determine the cause of such double vision.
Therefore, it is always recommended in case of acute double vision to go immediately an eye emergency room. How can it be treated? Is surgery necessary?
Surgical interventions are performed to correct double vision and diplopia only when the disease or the double vision cannot be treated by means of prismatic correction. Surgery is carried out in case of eye misalignment. In most cases, the patient goes back home the same day of surgery. Procedure is performed under topical anesthesia effects with some kind of sedation. In some very specific cases, it may be performed under the effects of general anesthesia.
After a strabismus surgery, the recovery time is relatively short. Usually, patients may resume their daily tasks job, studies… within the first week after the surgery. Nevertheless, patients may experience some discomfort, such as foreign body sensation or the feeling that something scrapes their eyes, but this evolves favorably and, some weeks after, discomfort completely disappears.
It is, however, recommended for patients to avoid going to the beach or swimming pool, as well as to not perform any sports contact during approximately the first 10 to 20 days.
The patient will need to follow a treatment with eye drops during the first month and to attend the required control visits. Usually, a control visit is scheduled 24 hours after surgery. Then, contingent upon the evolution, we carry out another control visit after a week. What is strabismus? Strabismus regardless of age is a condition in which the eye axes are not parallel or aligned with the object of fixation.
What […]. Symptoms Macular epiretinal membrane causes a slow and progressive visual loss lasting months or years, and affecting one or both eyes. Generally, it causes image distortion, and undulation of straight lines. Numbers and letters can appear to be in another line, and perception of colors may be decreased. What is strabismus in childhood? Ocular deviation can be horizontal in or out or can be vertical up or down and can appear at any age and for different reasons.
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Opening hours: Monday to Friday from a. Telephone number 10 10 Opening hours: Every day from 3 p. Telephone number 34 09 ICR Eye conditions Double vision or diplopia. Medical content revised by Dr. What is diplopia? Double vision or diplopia What types of diplopia are there?
Who is at a higher risk of experiencing double vision? Why do I see double? Causes of diplopia How is a diagnosis made? Is it serious? Do I need to go to an emergency room? If surgery must be performed, what does it entail? And what about the postoperative period? Double vision may be: horizontal , when overlapping images stand side by side; vertical , when images stand one on top of the other; or oblique , when images overlap diagonally.
Causes of monocular in one eye double vision Causes of binocular in both eyes double vision Refraction errors Crystalline lens conditions, such as cataracts Corneal diseases Retinal alterations, such as epiretinal membranes Strabismus Nerve palsies or malfunctions Alterations in central nervous system Thyroid problems or muscular diseases It requires an urgent examination in order to rule out more serious conditions.
What types of diplopia are there? Double vision persists even when closing an eye alternately. Binocular diplopia. Double vision disappears when closing an eye, and the cause is always an eye misalignment. Causes of diplopia Causes are classified depending on the type of double vision monocular or binocular. Some of its causes may be: eye alterations, such as refractive errors , which means that the patient requires glasses but does not wear any type of correction means, in which case it could be corrected by wearing glasses; problems in the crystalline lens, such as cataracts , which may lead to experiencing double vision in that eye; corneal diseases such as scars or opacities in the cornea; or retinal alterations, such as epiretinal membranes , which are membranes growing on the retina.
Some of its causes may be: an strabismus , which could be decompensated, i. Other factors such as thyroid problems or even mechanical problems in the extraocular muscles may also lead to eye misalignment. How is a diagnosis made? Related videos. Related articles. Strabismus What is strabismus?
If you keep on surfing this website, it shall be deemed to have acknowledged its use. More information. Refraction errors Crystalline lens conditions, such as cataracts Corneal diseases Retinal alterations, such as epiretinal membranes. Strabismus Nerve palsies or malfunctions Alterations in central nervous system Thyroid problems or muscular diseases.
Double vision or diplopia
Diplopia is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, diagonally i. 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. Diplopia has a diverse range of ophthalmologic, infectious, autoimmune, neurological, and neoplastic causes:. Diplopia is diagnosed mainly by information from the patient. Doctors may use blood tests, physical examinations, computed tomography CT , or magnetic resonance imaging MRI to find the underlying cause.