Diplopia, from the symptom to the diagnosis

Background This overview gives a rough frame how to proceede to a quick dia gnosis and possible differential diagnosis in patients with diplopia. Method A thourough interview concerning the onset of symptoms, invariabilit y, and subjective perception is mandatory. The first step before examining ocular motility is to verify monocular or binocular double vision. When the reported diplopia is binocular, the examiner can carry out the red-glas te st to determine the site of the double image. In a next step monocular rang e of movement in the 9 directions of gaze is evaluated to search for incomi tance. Results The main causes of diplopia are palsies of the oculomotor nerves, m echanical restriction - posttraumatic or inflammatory -, supranuclear lesio ns and disturbed neuromuscular junction. Conclusion With a simple and clear diagnostic diagram ist is easy to work o ut the underlying cause of diplopia.