3-Diplopia (2)

Strabismus.

To measure strabismus.

Esotropia.

By shining a light in the patient's eyes and observing the reflection on the corneas.

Infantile esotropia occurs in children less than 6 months old.

Congenital and acquired.

Double vision.

A neuromuscular disorder that affects the muscles controlling eye and eyelid movement.

An autoimmune condition affecting the eyes, often associated with thyroid disorders.

Strabismus surgery.

Abduction of the eye.

Moving the eye towards the nose.

Vascular issues, specifically posterior communicating artery (PCOM) aneurysm.

Droopy eyelid.

Oculomotor nerve palsy, causing ptosis, dilated pupil, and inability to move the eye in certain directions.

Onset and orientation, constant vs intermittent, and associated symptoms.

Posterior communicating artery aneurysms.

Levator palpebrae superioris (LPS) and superior rectus (SR).

Esotropia and exotropia.

To assess the presence of ocular myasthenia gravis by observing improvement in ptosis or diplopia after cooling the eyelids.

True strabismus.

Eye deviation.

To assess ocular alignment and detect strabismus.

Abducens nerve palsy, leading to inability to abduct the eye.

25%.

It indicates the degree of strabismus present.

CT/CTA.

CN6 palsy.

A condition where the eyes do not properly align with each other during gaze in children.

In diagnosing conditions like myasthenia gravis or other neuromuscular disorders.

A disorder that affects the muscles and the nerves that control them.

Intermittent XT, constant XT, and sensory XT.

CN3 palsy can cause both horizontal and vertical diplopia.

They contract to produce movement and maintain posture.

It occurs in a non-seeing eye.

It attaches to acetylcholine receptors (AChR’s) on skeletal muscle to initiate contraction.

Diplopia (double vision) and inability to move the eye laterally.

Drooping of the upper eyelid.

CT scan of the orbit.

Chronic Progressive External Ophthalmoplegia, a muscular condition that can cause diplopia.

Cranial Nerve VI (Abducens nerve).

Aneurysms, tumors, or diabetes.

It controls lateral eye movement.

Abnormal head posture.

50 - 75%.

Congenital factors can lead to IOOA SOUA.

Moving the eye towards the ear.

Head trauma can cause IOOA SOUA.

Moving the eye upward.

Autoimmune inflammation of the extraocular muscles (EOM).

CN4 palsy.

To assess eye alignment and detect strabismus.

Myasthenia gravis.

Medial rectus (MR), inferior rectus (IR), and inferior oblique (IO).

Crossed eyes, squinting, or difficulty focusing on objects.

An ice pack is placed over the eyelids for a few minutes, and then the patient's eyelid position is evaluated.

It helps in diagnosing the underlying cause and determining the appropriate management.

A staring look.

Constant strabismus is always present, while intermittent strabismus occurs occasionally.

Extraocular Muscles.

Management may include medications, radiation therapy, and surgery in severe cases.

It corrects with glasses for hyperopia.

Neurological disorders, trauma, or previous eye surgery.

Mouth, esophagus, stomach, intestines, liver, pancreas, and gallbladder.

Fatigable, worse towards the end of the day, and intermittent.

Restriction of muscle.

Misalignment of the eyes.

Horizontal diplopia.

Trochlear nerve, resulting in difficulty looking down and inwards.

A type of double vision that occurs under normal conditions, often when looking at objects at different distances.

Intracranial aneurysms, compressive lesions in the cavernous sinus, diabetes mellitus, and trauma.

When viewing objects at varying distances, particularly when one eye is fixated on a near object and the other on a distant object.

Diabetes and hypertension.

Moving the eye downward.

Ptosis (drooping eyelids) and diplopia (double vision).

Repetitive muscle contractions or sustained muscle activity.

One eye is covered while observing the uncovered eye for movement.

Double elevator palsy.

Parasympathetics for pupil constriction.

It indicates a misalignment or strabismus in the covered eye.

Diagnosis is typically made through clinical examination and imaging studies.

Causes can include trauma, tumors, vascular issues, or increased intracranial pressure.

Infantile (<6 months) and Acquired (6 months - 7 years).

If the strabismus is stable.

Intermittent fatigable diplopia and/or ptosis.

It can lead to double vision (diplopia).

The heart, blood vessels, and blood.

Superior oblique muscle.

To transmit signals between different parts of the body and coordinate responses.

The skin.

Incyclotorsion, depression, and abduction of the eye.

Vertical/torsional diplopia and head tilt.

To assess the endurance and fatigue levels of a muscle or muscle group.

Differential Diagnosis.

The light reflection should be centered on the cornea of both eyes.

Through patching if needed.

CN4 palsy.

No, it is usually temporary and resolves when the eyes are aligned properly.

Tumors can be a cause of IOOA SOUA.

Strabismus is a condition in which the eyes do not properly align with each other when looking at an object.

It is caused by the brain's inability to fuse images from both eyes when they are not aligned.

An aneurysm can cause IOOA SOUA.

Myasthenia Gravis (MG).

Brown syndrome.

Esotropia (50 - 75%).

Eyewear, vision therapy, or surgery.

Paralysis or weakness of the eye muscles.

Muscle fatigability and weakness.

Through clinical examination and imaging studies to identify underlying causes.

A condition where the eyes do not properly align when looking at an object.

Oculomotor (III), Trochlear (IV), and Abducens (VI).

To facilitate gas exchange, primarily oxygen and carbon dioxide.

Through clinical examination and imaging studies.

Trauma, vascular disease, or tumors.

Diplopia.

Treat the underlying cause.

Limited right supraduction, infraduction, and adduction, along with ptosis.

Refractive errors (glasses).

The ability of muscles to sustain activity over time.

To transmit signals between the brain and other parts of the body.

It is rare.

Myasthenia gravis, thyroid issues, focal neurological deficit, and high intracranial pressure (ICP).

Proptosis.

Oculomotor nerve.

Constant diplopia occurs all the time, while intermittent diplopia occurs occasionally.

Eyelid retraction.

Esotropia (inward turning of the eye) and exotropia (outward turning of the eye).

Limited abduction of the right eye.

Prism glasses (stick on Fresnel or ground in).

Acetylcholine receptor antibodies (AChR - Ab’s) bind to AChR’s and reduce their number.

Treatments include medications like anticholinesterase agents, immunosuppressants, and in some cases, surgery.

To provide structure, support, and protection to the body.

Trochlear nerve.

Vertical diplopia (double vision).

Through a comprehensive eye examination and assessment of eye alignment.

Management may include prism glasses or surgery in severe cases.

To defend the body against pathogens and diseases.

Diabetes Mellitus (DM), Hypertension (HTN), dyslipidemia, infections (URTIs), vaccinations.

Treat the underlying cause (e.g., MG, Thyroid, intracranial pathology).

Symptoms include bulging eyes, dryness, irritation, and vision changes.

A condition resulting from the dysfunction of the sixth cranial nerve, affecting lateral eye movement.

Patching one eye.

It is caused by an autoimmune response that affects the muscles and tissues around the eyes.

It can lead to amblyopia or double vision if not treated.

A noticeable improvement in eyelid droop or double vision after the ice pack is removed.

Tumour, microvascular occlusion, trauma, aneurysm, raised intracranial pressure.

Early detection can lead to more effective management and treatment.

A type of strabismus that occurs due to focusing efforts, often seen in children who are farsighted.

To control eye movements.

Prism glasses to help align vision and reduce diplopia.

It partially corrects with glasses for hyperopia.

Double vision, eye strain, and difficulty with depth perception.

Droopy eyelids and/or diplopia.

Head tilt towards the unaffected side.

It is caused by an autoimmune response that disrupts communication between nerves and muscles.

Ptosis, ophthalmoplegia, and dilated pupil.

Latent strabismus, present when breaking fusion.

Through clinical examination, blood tests for antibodies, and electrodiagnostic tests.

Thyroid Eye Disease (TED).

Botox in the muscle.

Restriction of extraocular muscles in any pattern.

Strabismus that is not related to focusing efforts and does not improve with glasses.

Six.

Diplopia (double vision).

Causes can include trauma, tumors, or increased intracranial pressure.

Dysarthria, dyspnea, dysphagia, and muscle fatigue.

Skeletal, cardiac, and smooth muscle.

To regulate bodily functions through hormones.

Childhood strabismus, previous strabismus surgery, previous episodes of diplopia, lazy eye.

Because it can mimic other conditions due to its symptoms.

There is no significant refractive error.

CN6 palsy, thyroid eye disease, Myasthenia gravis, sensory ET (non-seeing eye such as retinoblastoma).

Options include glasses, prisms, vision therapy, and surgery.

Ptosis.

Weak orbicularis.

Neurosurgery.

Episodes of diplopia.