Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center

Abstract

iplopia is a common symptom in ophthalmological and neurological diseases and this symptom affects the quality of life to a great extent. Once the patient is disturbed from diplopia, it must be determined whether diplopia is monocular or binocular. While monocular Etiology and Treatment Outcomes in Patients with Binocular Diplopia: Experience of a Tertiary Center A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Diplopia is a common symptom in ophthalmologic and neurological diseases. In the presence of binocular diplopia, investigation should be made for differential diagnosis. Detection of the underlying etiology provides early diagnosis of accompanying neurological diseases and facilitates the treatment of diplopia. In this study, we aimed to evaluate the causes of binocular diplopia, treatment modalities and treatment outcomes in a tertiary center. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Medical records of patients with binocular diplopia were reviewed. Demographic features and ophthalmological examination findings were noted. Etiological differential diagnoses of diplopia were elucidated according to the results of full ophthalmological examination and neuro-radiological evaluation with cranio-orbital magnetic resonance imaging. Treatment modalities and responses to these treatments were noted. R Re es su ul lt ts s: : A total of 70 patients were evaluated. Thirty-six patients (51.4%) had cranial nerve palsies. Of 36 patients, 61.1% had 6th nerve palsy, 22.2% 3th nerve palsy and 16.7% 4th nerve palsy. Patients without cranial nerve palsies were also grouped according to the type of deviations. The most common deviations were acute-decompansated esotropia (21.2%) and agerelated esotropia (18.2%). Diplopia recovered in 8 patients (11.4%) after treatment of the underlying etiology. Nineteen (27.1%) patients were not treated due to spontaneous recovery. Prism glasses were prescribed in 22 (31.4%) patients. Twelve patients (17.1%) were operated. Six (8.6%) patients received Botulinum-A toxin injections. C Co on nc cl lu us si io on n: : In the presence of binocular diplopia, cranial nerve palsies should be investigated. Diplopia can resolve spontaneously. In cases with persistant diplopia, prism glasses, Botulinum toxin-A injection and surgery can be performed.