Diplopia

Clinic

• Diplopia is the medical term for double vision or seeing double
• The etiology of diplopia is either eye misalignment if diplopia is binocular or an optical phenomenon if it is monocular. Eye misalignment can occur due to a variety of causes.
• Innervation to extraocular muscles is provided by the 3rd, 4th, and 6th cranial nerves; thus, all three have to be working well on each side in order to maintain both eyes in the primary position and aligned with each other.
• The nuclei of all three of these cranial nerves originate in the brainstem (3rd and 4th in the midbrain and 6th in the pons).
• Diplopia can be one of the first signs of a systemic disease, particularly to a muscular or neurological process, and it may disrupt a person's balance, movement, or reading abilities.

Causes

Infectious/ Autoimmune	Neurological	Drugs	Ophthalmologic	Others
Botulism	Atypical parkinsonisms Esp MSA Progressive supranuclear palsy	Haloperidol	Cataract	Sinusitis
Diabetes	Damaged 3th, 4th & 6th cranial nerve	Fluphenazine	Lasik complications	Abscess
Graves disease	Migraine headaches	Chlorpromazine	Keratoconus	Trauma
GBS	Strabismus	Cannabis	Aniseikonia
Lyme disease	Increased ICP (compressing 6th cranial nerve)	Opioids
MS	Anisometropia	Drunkenness
Myasthenia gravis	Wernicke's syndrome	Salicylism
Orbital myositis	Brain tumor	Antipsychotics
		Fluoroquinolone antibiotics

Related disease

• Myasthenia gravis
• Guillain–Barré syndrome
• Papilledema

Related entities

• Ptosis
• Ophthalmoplegia
• Face palsy

Miasms

• SHBV
• STLE
• LBB

Remedies

Repertory			Photophobia	Eye pain	Headache
Due to Eye Injury (Bruise)	Arn	Diplopia+ Vertigo and agg upon looking downwards. Eye feels painful Eyes also feel		Sore/ Red/ Swollen/ Heaviness / Great weight Shooting/ Tearing Pain	Headache
With Headache	Gels	Diplopia mostly when looking sideways. Maybe ptosis Weak eyesight. Diplopia + astigmatism. Vertigo		Eyeballs feel sore when moved Heaviness of eyes	Pain above eyes and across the forehead Band like sensation is felt around the head Fullness in the head
Diplopia with Squint	Zinc	Left eye is more affected compared to the right eye. In addition to double vision, the objects may also appear elongated. Weak Eyes/ Dim vision.		Pain Dryness
With Ptosis	Caust	Diplopia may worse on looking sideways	+	Eyelids feel heavy Pressing pain Dryness in eyes
With Weak Eyes	Nat-m	There is eye strain, and the eyes get tired upon reading or writing. The vision may be blurred and the eye muscles get weak.		Eyelids feel heavy along with a pain in the eyes.
With Vertigo	Phyt	Dimness of vision,	++	Dull pain in eyes	Severe Headache
With Eye Pain	Bell	Objects may also feel crooked with double vision. The eye pain agg by movement.	+++	Deep eyes pain Shooting/ Aching / Stinging Eyes dryness + Burning sensation	Pain in Forehead / Temple along with Inflammation/ Ulcer of cornea.
Vertical Diplopia	Syph	One image of an object is seen lower than the other Eye Pain agg at night time. Droopy eyelids + Strabismus		+++
Horizontal Diplopia	Puls-n	Double vision Complaint of keratoconus	+++	Stitches in eyes Pressure in eyes Dryness of eyes