Diplopia: What to Double Check in Radiographic Imaging of Double Vision

When patients see double with both eyes open, known as "binocular diplopia," this may be a harbinger of underlying life-threatening causes. This article presents pertinent anatomy, critical abnormality, and radiographic features that should be double checked for in diplopia. Key areas requiring a double check using the acronym VISION include Vascular, Infectious and Inflammatory, the Scalp for giant cell arteritis, Sphenoid and Skull base in trauma, Increased intracranial pressure (pseudotumor cerebri), Onset of new headaches or psychosis, and Neoplasm. This article reviews the pertinent abnormalities and radiographic imaging critical to assess in patients with diplopia.