Diplopia Developed in Later Life, An Ophthalmologic Approach

Abstract

Patients suffering from double vision first are commonly suspected to have acquired a neurological disorder. Over many years, we have observed numerous elderly patients complaining of double pictures for distant objects but lacking any other neurologic symptom. For this condition, no other causality was found than aging; therefore, the name "Age-related Distance Esotropia" has internationally been accepted. These days we know that the onset of comitant strabismus may occur, not only in childhood but even in the late years of life. Physicians are generally unaware of this fact; thus, these patients fail to find timely help for their double vision. Other geriatric eye disorders, such as cataract and maculopathy, often lead to a loss of binocularity without causing diplopia, the only signs being blurred vision or the habitual closing of one eye. The treatment of this so-called "masked diplopia" by prismatic correction of the squint will restore clear binocular vision and improve the reading ability. To avoid expensive neurological examinations for ocular-caused symptoms, simple diagnostic methods have been described in this article to help distinguish between ocular and neurologic disorders.

Non-surgical correction of diplopia after stroke- a strong impact factor on quality of life-minireview

“…The presence and evaluation of diplopia starts with the ocular motility exam by testing ductions in all directions of the gaze. The motility is reduced or absent in the direction of the paretic muscle in a incomitant squint and mostly indicates a neurogenic palsy (26). The presence or absence of eye deviation is assessed by cover/uncover, alternate cover, and/or Maddox rod testing.…”