Diploia_Dr. Kurtz Flashcards
What are the differential diagnoses of an emergent diplopia?
If all oculomotor, including the pupil, and/or abducens nerve involved.
Pt is distressed,
Pt changes in mental status
Pt with severe headache
Pt with stroke (drooping on one side of the face)
What is considered comitant binocular diplopia?
size of the deviation is within 5 or fewer prism diopters in all positions of gaze
What is considered non-comitant binocular diplopia?
size of the deviation is greater than 5 prism diopters in some positions of gaze
What would you do if your pt has monocular diplopia?
check refraction for uncorrected astigmatism, and check ocular media to look for dislocated lens or opacities.
What are the comitancy testings?
muscle field testing projection tests (ex. foster torches)
In non-comitant binocular diplopia, which muscle of the eye causes exo deviation that’s greater on left gaze?
RMR
In non-comitant binocular diplopia, which muscle of the eye causes exo deviation that’s greater on right gaze?
LMR
In non-comitant binocular diplopia, which muscle of the eye causes eso deviation that’s greater on left gaze?
LLR
In non-comitant binocular diplopia, which muscle of the eye causes eso deviation that’s greater on right gaze?
RLR
What is Internuclear ophthalmolegia (INO)?
- Adduction of 1 or both eyes is impaired
- convergence is spared
- Nystagmus of the abducting eye only (unilateral nystagmus)
What would you think the pt has if you see bilateral internuclear ophthamoplegia (INO)?
suspect MS
When would you suspect a pt is having MS?
When they present with INO, especially bilateral in right age group, and if they have optic neuropathy, especially with (+) APD. Most MS pts also present with wearkness or paresthesia in arms and feet, stumbling, clumsiness, decreased bladder control and Uthoff’s sign.
What are the different categories of disorders that are associated with the complaint of diplopia?
- emergent
- refractive
- functional
- neuropathological
- mechanical
