DIPLOPIA

-Tejas

R. Mahire

BACKGROUND
Derived from 2 Greek words: diplous, meaning double, and ops, meaning eye. It is double vision caused by a defective function of the extraocular muscles or a disorder of the nerves that innervate (stimulate) the muscles. Both eyes are still functional but they cannot converge to target the desired object. One of the first signs of Systematic disease - May disrupt persons balance - Movement - Reading abilities

CLASSIFICATION
Binocular
Monocular
Temporary
Voluntary

Binocular :
-Result of the misalignment of the two eyes relative to each

other -The fovea of one eye is directed at the object of regard, the fovea of the other is directed elsewhere -The brain will perceive two images of one target object, as the target object simultaneously stimulates different, noncorresponding, retinal areas in either eye, thus producing double vision

Monocular :
-Diplopia can also occur when viewing with only one eye; this is

called monocular diplopia, or, where the patient perceives more than two images, monocular polyopia -Differential diagnosis of multiple image perception includes the consideration of: 1. Corneal surface keratoconus, a structural defect within the eye 2. A lesion in the anterior visual cortex 3. Non organic conditions 4. Sub-luxation of the lens

Temporary :
Can be caused by: -Alcohol intoxication or head injuries, such as concussion. -A side effect of the anti-epileptic drugs, anti-convulsant drug, the hypnotic drugs and the dissociative drugs -Tired and/or strained eye muscles, or by one crossing their own eyes at will

Voluntary : -Some people are able to consciously uncouple their eyes,

inducing double vision on purpose. -These people do not consider their double vision dangerous or harmful, and may even consider it enjoyable. -It makes viewing stereograms possible.

CAUSES

Cornea problems: Infections of the

cornea, such as herpes zoster, or shingles, Corneal scars,Dryness of the cornea

Lens problems: Cataract Muscle problems: Myasthenia gravis is

an autoimmune illness that blocks the stimulation of muscles by nerves inside the head. Graves disease is a thyroid condition that affects the muscles of the eyes.

Nerve

problems:

Guillain-Barre diabetes

Multiple sclerosis, syndrome, Uncontrolled

Brain problems: Strokes, Aneurysms,

Increased pressure inside the brain from trauma, bleeding, or infection, Brain tumors, Migraine headaches

SYMPTOMS
Double vision can occur by itself with no other symptoms. Depending on the cause, other symptoms may be present with double vision, such as: Misalignment of one or both eyes (a "wandering eye" or "cross-eyed" appearance) Pain with eye movements in one or both eyes Pain around the eyes, such as in the temples or eyebrows Headache Nausea Weakness in the eyes or anywhere else Droopy eyelids

TREATMENT
If weak eye muscles are the cause, or if a muscle has been pinched as a result of injury, surgery may help. Myasthenia gravis can be treated with medications. Graves' disease is often curable with surgery or medical therapy. Blood sugar in diabetes can be controlled with medicines and/or insulin. Eyerobics If double vision can't be reversed, treatments can help people live with double vision. Sometimes, this requires wearing an eye patch or special prism glasses to minimize the effect of double vision.