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Related Experiment Video

Updated: May 2, 2026

Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition
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Intermittent diplopia: a practical guide.

Wilco Perini1,2, Veron Verhorst2, Anne van den Berg2

  • 1Neurology, Amsterdam UMC, Amsterdam, The Netherlands w.perini@amsterdamumc.nl.

Practical Neurology
|April 30, 2026
PubMed
Summary
This summary is machine-generated.

Intermittent binocular diplopia requires a structured approach for accurate diagnosis. This method helps differentiate causes, from simple decompensation to serious conditions, ensuring timely and appropriate patient care.

Keywords:
CLINICAL NEUROLOGYEYE MOVEMENTSNEUROMUSCULARNEUROMYOTONIANEUROOPHTHALMOLOGY

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Area of Science:

  • Ophthalmology
  • Neurology

Background:

  • Intermittent binocular diplopia presents diagnostic challenges due to symptom variability.
  • Potential causes range from benign to severe pathologies.

Purpose of the Study:

  • To present a practical, four-step method for evaluating intermittent binocular diplopia.
  • To guide clinicians in differentiating causes and avoiding unnecessary investigations.

Main Methods:

  • Confirming binocular diplopia.
  • Assessing monocular ductions for deficits.
  • Determining strabismus comitance.
  • Evaluating fatigability for ocular myasthenia.

Main Results:

  • The outlined method facilitates efficient assessment of intermittent diplopia.
  • Identifies specific clinical scenarios requiring targeted investigations (e.g., giant cell arteritis, malignancy).
  • Distinguishes between fusional, neurological, and orbital causes.

Conclusions:

  • This systematic approach aids in avoiding missed diagnoses of serious pathology.
  • Provides guidance on appropriate referral pathways (orthoptic, ophthalmic, or neurological).
  • Recognizes specific neurological entities like ocular neuromyotonia and superior oblique myokymia.