[Diplopia: An important symptom in internal medicine!]

Area of Science:

• Ophthalmology
• Neurology

Background:

• Diplopia, or double vision, is a visual disturbance impacting daily life.
• It is crucial to differentiate monocular diplopia (ocular) from binocular diplopia (misalignment).
• Binocular diplopia diagnosis can be challenging, especially for non-specialists.

Purpose of the Study:

• To outline a systematic approach for diagnosing binocular diplopia.
• To highlight the diverse etiologies of binocular diplopia.
• To emphasize the importance of managing diplopia alongside underlying conditions.

Main Methods:

• Systematic clinical examination of patients presenting with binocular diplopia.
• Targeted ancillary testing to localize lesions along oculomotor pathways.
• Review of potential causes including neurological, muscular, and systemic disorders.

Main Results:

• A structured examination aids in localizing lesions in the brainstem, cranial nerves (III, IV, VI), neuromuscular junction, extraocular muscles, or orbit.
• Common causes include inflammatory, infectious, neoplastic, endocrine, and metabolic disorders.
• Temporary eye occlusion can alleviate symptoms while definitive treatment is pursued.

Conclusions:

• Binocular diplopia diagnosis requires a systematic approach to identify the precise location of the lesion.
• A wide range of systemic diseases can manifest as binocular diplopia.
• Effective management involves addressing the underlying cause and providing symptomatic relief.