Adult Diplopia (Double Vision)
“Diplopia” or “Double Vision” is the simultaneous perception of the same image in two distinctly different places in space. Images may be displaced horizontally, vertically or diagonally.
Diplopia is “binocular” when caused by ocular misalignment; when both eyes are not on the same vertical or horizontal plane. In binocular diplopia, the closure of either eye will eliminate symptoms. This type of diplopia is best evaluated by a strabismus surgeon (often a pediatric ophthalmologist) and can be treated with monocular occlusion, fusional amplitude exercises, prism glasses or eye muscle surgery.
Diplopia is deemed “monocular” when both images come from the same eye. In monocular diplopia, symptoms are alleviated only when the culprit eye is closed. For example, if the second image resolves when one closes the right eye, but not with closure of the left eye, both images are coming from the right eye. In this example, diplopia originates in a single eye and is not a binocular problem. This type of diplopia is best evaluated by a comprehensive ophthalmologist/subspecialist. Monocular diplopia may be associated with corneal, lens or retinal disease.
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