Diplopia
General characteristics of the disease
Diplopia is an ophthalmic pathology associated with double vision. Objects falling into the field of view of a person appear double as a result of the deviation of the axis of one of the eyes. Such disorders can be caused by a number of reasons of an ophthalmic, neurological or infectious nature.
Causes of diplopia
The development of diplopia can provoke a displacement in the orbit of the eyeball. It is often caused by eye injuries, for example, entrapment of the eye muscles caused by a fracture of the wall of the orbit. The abnormal position of the eyeball is also caused by hematomas of the eye tissues.
Another possible cause of diplopia is damage to the oculomotor nerve. It can be provoked by an aneurysm of the carotid artery, intracranial tumors or meningitis of tuberculous etiology.
The causes of diplopia are also infectious processes that have affected the brain stem in rubella, parotitis, diphtheria or tetanus. Severe alcohol or drug intoxication can also cause diplopia.
Image doubling or diplopia is often observed against a background of botulism, thyrotoxicosis, multiple sclerosis, or hysterical attacks. The cause of diplopia, as one of the types of postoperative complications, can be manipulations in the eyes during the surgical treatment of retinal detachment, strabismus or cataracts.
Diplopia symptoms
The main complaint of patients with diplopia is ghosting. In most cases, double vision of objects of the surrounding reality occurs when seeing with two eyes. This is how binocular diplopia is manifested. Double vision can be partial and displayed only in a certain area of the field of view or complete. The manifestation of diplopia is also individual, depending on the distance of the objects in question. In some cases, doubling occurs only when looking at closely located or, conversely, exclusively at distant objects.
Two images of the same object that occur with diplopia have different brightness and contrast. One of them is usually slightly offset vertically, as well as horizontally and is located at a certain angle to the second image.
Due to progressive diplopia, the patient loses work skills. It can be difficult for him to do housework, drive vehicles, and sometimes just get around. To restore the clarity of the image, a person with binocular diplopia has to close one of the eyes. For patients with another type of disease, monocular diplopia, this measure does not help.
Types of diplopia
Binocular diplopia is the most common form of double vision. In binocular diplopia, the visual picture of both eyes is not projected at the corresponding points of the retina. The visual axis shifts, and a patient with binocular diplopia sees a doubled image of objects. Binocular diplopia can be motor, sensory or mixed, permanent or temporary, neuroparalytic, orbital, trauma-induced, strabogenic with strabismus, etc.
Monocular diplopia is a rarer pathology of double vision. Disturbances in the image in this case occur even with vision with one eye. The projection of the image simultaneously on two different points of the retina of one eye leads to monocular diplopia. Monocular diplopia is most often caused by subluxation or partial opacity of the lens. Monocular diplopia can also be caused by iridodialysis (separation of the iris from the ciliated body as a result of eye injury) or polycoria (congenital iris structure with multiple holes).
Diagnosis of diplopia
The primary diagnosis of diplopia is based on the patient's complaints about double vision. Further diagnosis of the disease continues with the help of a test control over the vision of a person whose gaze is directed to a moving light source.
By mapping the coordinates of the images obtained, the doctor is able to diagnose which of the eye muscles is affected. A more modern method for determining the damaged extraocular muscle of the eye is coordimetry using an OK ophthalmic coordimeter.
Diagnosis of diplopia also involves a mandatory assessment of the state of the position and mobility of the eyelids using the Cover Test. Additionally, an examination of the conjunctiva of the eyeballs is carried out, visual acuity, refraction and color perception are checked.
Diplopia treatment
Treatment of diplopia of the secondary type of neurological, infectious or ophthalmic etiology involves therapy of the underlying disease.
Treatment of diplopia as the underlying disease is under the jurisdiction of a neuropathologist or neurosurgeon. In the treatment of diplopia of a traumatic nature, an ophthalmologist surgeon is involved in performing resection or plastic surgery of the eye muscles. At the same time, surgery on the eye muscles is allowed, as a rule, only 6 months after the injury.
Optical correction of diplopia is performed using prismatic glasses. They are able to significantly improve the clarity of the patient's vision. The optimal correction in the treatment of diplopia is 6 prism diopters per eye.
In rare cases, glasses with higher prismatic compensation may be worn. Fresnel prisms can have a power of up to 20 rd. Diopters, however, already with a compensation of 15 rd. Diopters, they affect visual acuity and create the effect of an iris around visible objects.
Functional treatment of diplopia consists in performing special exercises according to Kashchenko to restore the abilities of binocular vision and expanding the field of vision, as well as exercises for fusion of objects using red glass, etc.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
