Protocolo diagnóstico del paciente con diplopía

Abstract

Diplopia is the simultaneous perception of two images of a single object. It's a prevalent symptom caused by a wide range of etiologies, like myasthenia gravis (fluctuating diplopia) or Graves’ disease (thyroid ophthalmopathy). The most common cause of dipoplia is cranial ischemic neuropathy, in which three ocular motor nerves can be involved. A pupil-involving third nerve palsy requires angiography evaluation for the possibility of an intracranial aneurysm. Intracranial hypertension is a frequent cause of sixth nerve palsy. Fourth nerve palsy usually occurs after cranial trauma. The involvement of brain-stem structures causes complex conditions, among which internuclear ophthalmoplegia, usually of ischemic or demyelinating origin, is noteworthy. Diagnostic and therapeutic approach is achieved by detailed anamnesis and thorough physical examination.