Disease relevance of Diplopia

• Lamotrigine was associated with an increased risk of adverse events in the nervous system (dizziness, tremor, ataxia, and diplopia), gastrointestinal tract (nausea), and urinary tract (infection) [1].
• If, however, diplopia is due only to EOM or CN palsy, orbital surgery should be deferred (in the absence of significant enophthalmos) in favor of observation and/or later strabismus surgery [2].
• All anticonvulsants may cause unwanted neurological effects: when they occur, diplopia is usually precipitated by carbamazepine; tremor by valproic acid; and other motor disturbances are probably most common with phenytoin [3].
• Constant deviations of this type are classified as 'acute acquired concomitant esotropia'. Relief from the diplopia may be gained by prismatic correction, and the deviation may then resolve spontaneously [4].
• Twenty patients with strabismus and diplopia following surgery for retinal detachment were treated by botulinum toxin injection of the eye muscles [5].

High impact information on Diplopia

• Diplopia following ibuprofen administration [6].
• Diplopia completely resolved in two patients and improved in the third coincident with administration of cyclophosphamide [7].
• Usually, each patient's serum recognized a different autoantigen, except for adenomatous polyposis coli that was recognized by sera of two patients with idiopathic OM and two control patients with nystagmus, diplopia, and paraneoplastic brainstem dysfunction [8].
• Clinical images: Brown's syndrome: an unusual cause of diplopia in rheumatoid arthritis [9].
• Nodular pulmonary lesions developed twice, and diplopia and unilateral visual loss once, after reduction of the steroid dose [10].

Chemical compound and disease context of Diplopia

• Unless contraindicated, patients with diplopia were recommended for therapy with prednisone, up to 40 to 60 mg/d, with the dosage tapered for 5 to 6 weeks [11].
• The amount of MR path displacement with coronal surgery was inversely correlated with range of abduction and directly correlated with severity of horizontal diplopia [12].
• Diplopia with citalopram: a case report [13].
• Three patients had radiation-related complications, including diplopia (n = 2), ipsilateral blindness (n = 1), testosterone/growth hormone deficiency (n = 1), and asymptomatic temporal lobe radiation necrosis (n = 1): all had received prior radiotherapy [14].
• All volunteers reported adverse events; the most common were slurred speech (in 1 after 10 mg and in 5 after 20 mg of zolpidem), dizziness (in 4 after both 10 mg and 20 mg of zolpidem) and diplopia/blurred vision (in 4 after 20 mg of zolpidem) [15].

Biological context of Diplopia

• We found the following results: (1) inter-observer agreement is high; (2) both children and adults exhibit many atypical responses, whether or not they have normal binocular vision; (3) diplopia awareness does not differentiate between subjects with normal and abnormal binocular vision; and (4) 4 delta BO test results are not repeatable [16].
• DATA SYNTHESIS: Clostridium botulinum toxin blocks acetylcholine release in a dose-dependent fashion, resulting in acute symmetric diplopia, dysarthria, dysphonia, dysphagia, and possible neurologic sequelae despite the route of exposure (i.e., food-borne, wound, intestinal, inhalation) [17].
• The diplopia in SCA3/MJD cases is, therefore, attributed, at least in part, to the impairment of the vergence eye movements [18].
• Furthermore, the occurrence of a curious orthoptic abnormality is described, indicating one of the possible ways to avoid diplopia in chronic progressive external ophthalmoplegia: the coexistence of normal and gliding abnormal retinal correspondence [19].
• The pattern visual evoked potential (PVEP) was recorded from strabismic patients, three with childhood onset, two adult onset with diplopia, and three with longstanding adult onset strabismus "ignored" diplopia [20].

Anatomical context of Diplopia

• We describe a 67 year old woman who developed blurred vision, diplopia, left sided oculomotor palsy, and ipsilateral ptosis during steroid treatment for giant cell arteritis [21].
• Nystagmus, diplopia, and extraocular muscle palsies have been associated with central nervous system depressants, antihistamines, barbiturates, and elevated blood ethanol concentrations [22].
• The diplopia, which was diagnosed as abducent nerve paralysis, improved rapidly and reversed at about 6 weeks after discontinuation of interferon and during infusion of hydrocortisone [23].
• A case is reported where the onset of vertical diplopia secondary to a trochlear nerve palsy occurred as the presenting feature of polycythemia rubra vera [24].
• A 52-year-old Turkish man with familial Mediterranean fever (FMF) due to the homozygous M694V mutation in the MEFV-gene on chromosome 16p13.3, newly developed hemicrania, blurred and double vision, ptosis, ophthalmoparesis and peripheral facial nerve palsy [25].

Gene context of Diplopia

• Patients with chronic progressive external ophthalmoplegia and strabismus frequently have diplopia in primary position and may benefit from extraocular muscle surgery to improve alignment [26].
• A strong correlation between visual symptoms and ocular aberrations, such as monocular diplopia with coma and starburst and glare with spherical aberration, suggest this device is valuable in diagnosing symptomatic LASIK-induced aberrations [27].
• Brown's syndrome: an important cause of diplopia in systemic lupus erythematosus [28].
• CONCLUSIONS: Optical sequelae of glare, halo, and monocular diplopia may occur in some patients after either both PRK or LASIK for moderate to high myopia; in contradistinction, many other patients' preoperative symptoms improve after surgery [29].
• Exercise induced diplopia as a presentation of midline cerebral tumour [30].

Analytical, diagnostic and therapeutic context of Diplopia

• One patient in the 0.25% lidocaine group experienced a transient diplopia after tourniquet release [31].
• Fifteen patients with diplopia associated with prior scleral buckling, prior penetrating keratoplasty, severe corneal scarring, monocular aphakia, long-standing strabismus, or prior vertical offsets of the horizontal recti were thought to have disruption of fusion because diplopia could not be eliminated with prisms [32].
• A 23-year-old man with ALL developed dizziness, headache, diplopia, limb weakness, and a sensation of fullness in his head after his second induction chemotherapy with doxorubicin, prednisolone, and vincristine [33].
• After treatment with prednisolone and colchicine, the diplopia resolved [34].
• BACKGROUND: An adult strabismus clinic in a regional eye centre provided an opportunity to estimate the risk of postoperative diplopia from regional anesthesia after cataract surgery and to describe the management of these patients [35].

References