Diplopia Flashcards
Binocular diplopia
resolves if 1 eye closed
-most common, due to cranial nerve pathology
Monocoular diplopia
persists even if 1 eye closed
- intraocular cause (macular edema, corneal/lens pathology)
- central cause (CNS visual pathways)
CN Palsy etiologies
- ischemic
- traumatic
- compressive (ICP, aneurysm)
- NMJ disorder (myasthenia)
monocular dipolopia localization
-ocular defecect, refer to optho
binocular diplopia localization (disappears w/ 1 eye closed)
-neuro defect –> refer to Neuro
horizontal (side-to-side) images localization
CN3 or CN6
vertical (above and below) images localization
CN4 lesion
improves with head tilt localization
CN4 (if tilt toward unaffected side)
CN 6 (if tilt toward affected side)
symptoms worse with near focus localization
CN3
symptoms worse with distant focus
CN6
Sx worse at end of day localization
myasthenia
pain with eye movement localization
myopathy
CN3 palsy
findings:
- impaired “down and out” position
- diplopia worse when looking “up and in”
- ptosis + dilated pupil
etiology:
- intracranial compression by aneurysm at PCA or tumor
- ischemia or infarction?
CN 4 palsy
- vertical diplopia
- most severe when patient looks down and in
- naturally tilt head to unaffected side
etiology likely trauma or ischemic
CN6 palsy
horizontal diplopia (MOST COMMON DIPLOPIA)
- most severe with lateral gaze
- etiology: microvascular disease (DM), trauma, ICP
