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What is diplopia?

What is diplopia?

09 December 2021

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Diplopia is an alteration in vision based on the perception of two images of the same object. Diplopia can occur horizontally (the images are side by side); vertical (images are on top of each other) or oblique (images are both vertical and horizontal).

There are two types of diplopia, monocular and binocular.

Monocular diplopia: Double vision can be seen with only one eye open. This is due to changes in the structure of the eyeball, the most common being:

• Changes in the lens

• Corneal abnormalities

• Uncorrected refractive defects

• Macular degeneration

Binocular diplopia: it occurs when we use both eyes and disappears when either of the two is closed. It is the most common, caused by the lack of parallelism in the eyes due to changes in the oculomotor nervous system.

Although there are many diseases that affect the alignment of the eyes, the most common are:

• Childhood strabismus

• Oculomotor paralysis

• Nervous system disease (myasthenia gravis)

• Thyroid disease

• Brain tumor

• Trauma to the head and eye

• High myopia

Sometimes patients with binocular diplopia tend to tilt their head to try to compensate or see more clearly, and may end up with chronic neck pain (torticollis).

Double vision can prevent or hinder the performance of daily activities, generating a disability in the patient. The diagnosis will depend on the cause of the diplopia. Among the treatments we can find:

• The use of prisms, which are glasses that shift the image to eliminate double vision. They are prescribed in small deviations.

• Botulinum toxin, which can be useful in some cases of oculomotor paralysis.

• Surgery, if the diplopia cannot be corrected with the previous alternatives.

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