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Updated: Jul 12, 2026
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Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition
Published on: July 21, 2020
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Binocular diplopia: a retrospective study of 204 cases
M Saint-Gerons1, M A Rubio2, A Matheu1
1Unidad de Neuro-Oftalmología, Departamento de Oftalmología, Hospital del Mar, Barcelona, Spain.
Neurologia
|March 21, 2025
Summary
Fourth nerve palsy was the most common cause of binocular diplopia, followed by sixth nerve palsy and decompensated strabismus. Understanding these frequencies aids in prioritizing diagnostic imaging for diplopia.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
Background:
- Binocular diplopia is a common presenting symptom with diverse underlying etiologies.
- Accurate etiological diagnosis is crucial for appropriate management and patient outcomes.
Purpose of the Study:
- To determine the prevalence and patterns of onset for various causes of binocular diplopia in a tertiary care setting.
Main Methods:
- A retrospective, cross-sectional study was conducted on 204 patients presenting with binocular diplopia.
- Data included demographic variables, ocular deviation, diagnostic test results, and etiological diagnosis following neuro-ophthalmological evaluation.
Main Results:
- Fourth nerve palsy (19.12%), sixth nerve palsy (14.71%), and decompensated strabismus (14.22%) were the most frequent overall causes.
- Acute onset diplopia was most commonly due to sixth nerve palsy, while subacute/chronic onset was often caused by decompensated strabismus and sagging eye syndrome.
Conclusions:
- Fourth nerve palsy, sixth nerve palsy, decompensated strabismus, and sagging eye syndrome are leading causes of binocular diplopia in this population.
- Knowledge of etiological frequencies can guide the prioritization of neuroimaging investigations.
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