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Double
vision
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Double vision (diplopia) occurs when a
patient fixates on a single object, but perceives two
objects instead. Caused by a number of disorders,
diplopia can be monocular or binocular.
- Monocular diplopia does not go away when either eye is closed. This type of diplopia can be caused by defects in the front part of the eye involving the cornea and lens, such as corneal scars, Cataracts, or the
need for glasses.
Binocular diplopia, however, does go
away when either eye is closed. It is caused by a
misalignment of the eyes, which can be secondary to many
disorders, most often neurogenic (nerve related) or
myopathic (muscle related).
Cranial nerves III, IV, and VI, responsible for moving the eye, may produce double vision if any of their functions are disturbed. Myasthenia Gravis,
which also affects eye muscles, may cause double
vision.
Slowly developing diplopia may suggest
a growing tumor compressing the cranial nerves mentioned
above.
In elderly patients with intermittent diplopia, Giant Cell Arteritis
and ischemic vascular disease must be considered as possible
causes.
Diplopia can also occur following eye surgery and injury to the orbit of the eye.
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