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Familial intermittent diplopia: a report of two cases
Aviation, Space, and Environmental Medicine
|July 1, 1982
Summary
Maintaining binocular vision is crucial in aviation. Despite concerns, diplopia (double vision) is rare in flight, with most cases identified through patient history rather than testing.
Area of Science:
- Ophthalmology
- Aviation Medicine
- Neurology
Background:
- Ensuring adequate muscle balance and bifovial fixation to prevent diplopia under challenging conditions (hypoxia, fatigue, stress) has been a long-standing concern in aviation medicine since 1917.
- Current testing procedures for fusion breaks are resource-intensive and may exceed the skill level of many examiners, despite the rarity of inflight fusion breaks.
Observation:
- A 54-year-old employee presented with a 5-year history of daily, incapacitating diplopia episodes.
- His 48-year-old brother reported a similar history of intermittent diplopia.
- Both individuals exhibited normal vision test results when asymptomatic.
Findings:
- Diplopia detection in these cases was primarily based on patient history, not objective testing.
- The diagnosis for these recurrent diplopia episodes remains uncertain.
- The study highlights the potential for diplopia to be concealed and the limited value of standard tests in certain cases.
Implications:
- The findings question the efficiency and effectiveness of current diagnostic methods for certain types of diplopia in aviation personnel.
- Reaffirms the critical importance of detailed patient history in diagnosing visual disturbances like diplopia.
- Suggests a need to re-evaluate diagnostic protocols, considering the ease of concealment and the limitations of objective testing.