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Diplopia after cataract surgery.

Rod Foroozan1, Anthony C Arnold

  • 1Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.

Survey of Ophthalmology
|December 29, 2004
PubMed
Summary
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A 69-year-old man experienced double vision after cataract surgery. Treatment for an epiretinal membrane resolved his symptoms, highlighting a rare cause of diplopia.

Area of Science:

  • Ophthalmology
  • Neuroscience

Background:

  • Binocular diplopia is a common visual disturbance.
  • Macular pathologies are typically associated with central vision loss, not typically diplopia.

Observation:

  • A 69-year-old male developed binocular vertical diplopia post-bilateral cataract surgery.
  • Funduscopy revealed an epiretinal membrane (ERM) in the macula, more prominent in the left eye.
  • The patient experienced worsening metamorphopsia and decreased visual acuity in the left eye.

Findings:

  • The patient had a 2 prism diopter right hypertropia, which was comitant but unresponsive to prisms.
  • Pars plana vitrectomy with ERM removal led to complete resolution of diplopia.
  • This case suggests macular ERMs can cause binocular diplopia via foveal displacement and disrupted fusional mechanisms.

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Implications:

  • Epiretinal membranes should be considered in the differential diagnosis of unexplained diplopia, especially post-ophthalmic surgery.
  • Understanding the mechanisms of foveal displacement and sensory rivalry is crucial for managing such cases.
  • Surgical intervention for ERMs can effectively treat associated diplopia, improving patient outcomes.