Diplopia

Question 1

what is it, and is it worrying?

Answer 1

Double vision, very worrying

want to know onset, character, duration, associated (pain), triggers/alleviators (randomly, during reading, etc)
Get better when cover 1 eye?

IS it doubling along X axis or Y axis

Question 2

What is it often caused by?

Answer 2

Muscular issues and the eyes not focusing together
OCCULAR MISALIGNEMENT

e.g. 3rd nerve pasly- (expect rectus problem + dilated pupils)
Horizontal-often the lateral muscles or their pathways. where on pathways
Ve

Question 3

Explain 3rd nerve pasly?

Answer 3

In surgical cause-dilated pupil BEFORE the down and out because often something crushing on nerve exterior (where PSNS is)

In medical cause-get down and out before the dilated pupil (because ischemia-center of nerve and not much exterior)

Question 4

What are causes of diplopia

Answer 4

3rd nerve pasly, horners, Myasthesia gravies (fatiguable eyes), giant cell arteritis. fasciculus nuclear issues in the Pons

Question 5

What are investigations to do?

Answer 5

Bloods works (ESR-giant cell arteritis)
head MRI kind always important