Diplopia Research Articles

The local and ethnic specifics of Yunnan in the work of modern Chinese artists: an "inside" and "outside" view

The article is devoted to the reflection of local and ethnic specifics (mainly Yunnan Province and the Tibetan borderland) in the works of Chinese artists of the Reform and Opening Up period – Jin Shangyi, Wang Yidong, Zhang Jian Jun, Yuan Yunsheng, Ai Xuan, Zeng Xiaofeng, Ma Yun, Mao Xuhui, Zhang Xiaogang, Liao Xinxue and Liu Ziming. Various cultural codes within which ethnic and local culture is interpreted in the paintings of visiting and local artists are identified. These differences in the perception and display of ethno-local specifics are especially evident when artists paint the same ethno-local object – for example, the life of Tibetan ethnic minorities. The glamorous characters of the Tibetan cycle of Zhang Jian Jun and Ai Xuan are strikingly different from the stern Tibetan women in the paintings of Zhang Xiaogang. The main conclusion of the study is that artists of various trends have their own ideological and aesthetic intentions, so they select individual figurative dominants from the whole variety of phenomena of tradition and everyday life of the ethnic group and build them into a new cultural code. It can be argued that the exotic cultural code (the view from the outside, characteristic mainly of visiting artists) presupposes “estrangement” and the dominance of aesthetic form to the detriment of ethno-cultural specifics, while the archaic code (the view from the inside) complements modern ethno-local elements with historical-cultural (folklore) examples. Artists of the esoteric type of coding possess “double vision”: they accurately reproduce the cultural landscape of Yunnan and the “life world” of ethnic minorities, but interpret it through individual optics, using world artistic experience.

72-Year-Old Woman With Double Vision, Dysarthria, and Ptosis

72-Year-Old Woman With Double Vision, Dysarthria, and Ptosis

Vision Evaluation Processes Described by Pediatric Occupational Therapists: A Qualitative Study

ABSTRACT Vision deficits can impact areas of occupation and limit one’s ability to function academically and socially, making it essential for assessing and treating children with developmental delays and acquired brain injuries. This qualitative study describes the occupational therapist’s process when completing vision evaluations in pediatric settings such as schools and early intervention, where data was analyzed utilizing thematic analysis. Twenty-one occupational therapists with at least one year of experience in pediatrics and vision evaluations who completed structured interviews were included in the study. Purposive sampling and snowball recruitment were used. Common symptoms seen with children who display visual deficits indicated by participants include headaches, double vision, and clumsiness. Common difficulties shown by children with visual deficits indicated by participants were reading, handwriting, and difficulty copying. Two themes were created based on the data analysis: exploring how OTs benefited from the partnership with optometrists when treating visual deficits and the significance of how the visual system plays in a child’s overall functioning. Pediatric OTs can be among the first team members to note concerns impacting their occupational performance. With this knowledge, OTs can help children progress academically and become more independent.

Motor polyradiculoneuropathy as an unusual presentation of neurobrucellosis: a case report and literature review

Brucellosis, a zoonotic disease caused by Brucella species, poses a significant global health concern. Among its diverse clinical manifestations, neurobrucellosis remains an infrequent yet debilitating complication. Here, we present a rare case of neurobrucellosis with unusual presentations in a 45-year-old woman. The patient’s clinical course included progressive lower extremity weakness, muscle wasting, and double vision, prompting a comprehensive diagnostic evaluation. Notable findings included polyneuropathy, elevated brucella agglutination titers in both cerebrospinal fluid and blood, abnormal EMG-NCV tests, and resolving symptoms with antibiotic therapy. The clinical presentation, diagnostic challenges, and differentiation from other neurological conditions are discussed. This case underscores the importance of considering neurobrucellosis in regions where brucellosis is prevalent and highlights this rare neurological complication’s distinctive clinical and radiological features. Early recognition and appropriate treatment are crucial to mitigate the significant morbidity associated with neurobrucellosis.

EYE PLASTIC SURGERY FOR SEVERE ORBITOPATHY: RESTORING EYE HEALTH AND QUALITY OF LIFE

Graves' orbitopathy is a complex and debilitating ophthalmological condition often associated with the autoimmune thyroid disease known as Graves' disease. Characterized by inflammation and swelling of the tissues around the eyes, Graves' orbitopathy can lead to a range of serious symptoms, such as proptosis (bulging eyes), diplopia (double vision), eye pain and impaired visual function. Eye plastic surgery emerges as an important therapeutic approach to restore not only ocular health, but also the quality of life of affected patients, aiming to correct the physical and functional deformities associated with the condition. However, critical evaluation of the scientific literature on the topic is essential to understand the effectiveness, safety and results of the different surgical procedures used in this context. Objective: The objective of this systematic review is to analyze studies published in the last 10 years on ocular plastic surgery for Graves' orbitopathy, with the aim of evaluating the effectiveness, safety and results of the different surgical procedures used to treat this condition. Methodology: Using the PRISMA checklist, articles were searched in the PubMed, Scielo and Web of Science databases, published between 2012 and 2020. The descriptors used were "Graves' Orbitopathy", "Ocular Plastic Surgery", "Thyroid Eye Disease" , "Graves' ophthalmopathy" and "eyelid reconstruction". and "eyelid reconstruction". Inclusion criteria: studies in English, evaluating surgical procedures for Graves' orbitopathy, with clinical and quality of life results. Exclusion criteria: duplicate studies, samples unrelated to Graves' orbitopathy and without relevant clinical results. Results: The main topics covered by the studies include surgical techniques, visual results, postoperative complications and impact on patients' quality of life. Conclusion: The systematic review highlights the importance of ocular plastic surgery in the management of Graves' orbitopathy, providing insights into the most effective and safe surgical approaches to restore ocular health and quality of life to affected patients.

Di-vision/double vision

The conference theme ‘Between excess and austerity’ indicates a division which has shaped the discipline of interior design during the twentieth century. This paper is the outcome of a desire to open up this binary relation which continually dogs the practiceof interior design. The writings of Gilles Deleuze, in particular his attempt to ‘overturn Platonism’, are used as a tool to lever and open up possibilities for thinking differently. The immediate effect is that in between excess and austerity one encounters an ‘and’ – excess and austerity – hence the title of the paper ‘di-vision/ double vision’. Rather than between or either/or, it is both. This produces a blurring of vision which problematises the distinction made between interior design and interior decoration based on questions of excess and austerity as one equated with ornamentation versus the essentialism of a minimal aesthetic. This paper considers three familiar modernist surfaces from the twentieth century. Looking through glasses provided by the writings of Deleuze, the Platonic nature of the surfaces is apparent but so too are other ways of viewing these surfaces – division becomes di-vision or double vision and the possibilities for other ways of thinking and doing proliferate. The question of excess and austerity shifts from one of ‘to decorate or not?’ to one where the binary is blurred and the between becomes ‘and’ rather than a between of moderation. This involves an epistemological shift from a search for essences and ideals to an encounter with surfaces where meaning and events happen in which the proliferating intensity of life can be both austere and excessive.

Efficacy of Yashtimadhu Ghritha Tarpana in Computer Vision Syndrome

Computer Vision Syndrome is the name given to eye problems caused by prolonged computer use including: Eye irritation (Dry eyes, itchy eyes, red eyes) Blurred vision, Headache. As we enter the 21st century, the growing use of Video Display Terminal (VDT) like Computer, Tablet, Smart phones etc. in the home and office brings with it an increase in health risks, especially for the eyes. One eye problem, called Computer Vision Syndrome (CVS), is afflicting more and more people who find themselves constantly in front of Video Display Terminal. Symptoms of Computer Vision Syndrome include Headache, Blurred vision, Burning sensation, Fatigue, Dry eyes, Irritated eyes, Double vision, and Difficulty re-focusing the eyes. These symptoms can be further aggravated by improper lighting conditions and air moving fast the eyes. Dry eye is a major symptom that is targeted in the therapy of computer vision syndrome. Acharya Susrutha mentioned Tarpanam, Putapakam, Sekam, Acshyothanam, Anjana the Kriya Kalpas for Netra Rogas. Tarpana is indicated when the eyes are fatigue inactive, Sushka (dry), Ruksha (rough), injured, patients of Vata and Pitta vitiation, when there is squint, loss of lashes, clouded vision, difficulty in opening the eyes etc. conditions, Tarpana should be done to the patients.

Clinico demographic profile and short-term outcome of Pediatric Idiopathic Intracranial Hypertension in a tertiary care hospital of Bangladesh

Background: Diagnosis of IIH (idiopathic intracranial hypertension) in children is challenging. The pathogenesis of IIH is still largely unknown. The aim of this study to evaluate the clinico-demographic profile and short-term outcome of IIH among Bangladeshi children. Methodology: This observational cohort study was done in pediatric Neurology Department, National Institute of Neurosciences and Hospital Bangladesh from January 2018 to July 2019. Total 19 cases were enrolled who were clinically suspected and/or had normal CSF with opening pressure (OP) above 250 mmH2O. They were further categorized as “definite IIH”, definite IIH without papilledema, and “probable IIH”. Clinical, radiological profile and short-term outcome were analyzed by SPSS version 22. Result: Among them most were probable IIH (74%). Episodic (57.9%), moderate, diffuse headache was the predominant symptom along with vomiting, double vision, unilateral VI nerve palsy and papilledema. Obesity was found in 21% cases. Mean CSF pressure was 21.84+7.62cm H2O and found high in definite IIH. All the cases were treated with acetazolamide and serial LP was done in 4(15.8%) cases. Definite IIH requires longer hospital stay (6.42 ± 2.87days). Recurrence was observed in 10.5% cases and visual impairment was found in 15.8% cases. Conclusion: This study found wide range of diversity between clinical feature and CSF opening pressure in Pediatric IIH and diagnostic confirmation was challenging. Initial treatment response was satisfactory with a low recurrence rate. J Bangladesh Coll Phys Surg 2024; 42: 161-168

The Riddle of the Double Vision-A Rare Case of Intracranial Tumor: When Imaging Resolves the Mystery.

A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread.

Use of Big Data to Evaluate Adverse Ophthalmic Adverse Events after COVID-19 Vaccination

Purpose: This study explored the types and incidences of adverse ophthalmic adverse events after COVID-19 vaccination and their associations with such vaccination in patients who presented to the sole local, tertiary, general hospital in region Ulsan of South Korea complaining of ophthalmic discomfort after COVID-19 vaccination.Methods: This cross-sectional study was conducted at Ulsan University Hospital, which is the only tertiary general hospital in Ulsan city. All participants visited the hospital from March 2021 to August 2022 complaining of ophthalmic discomfort after COVID-19 vaccination. Clinical variables were collected from both our clinical data warehouse and the electronic medical records of the hospital.Results: To date, 2,766,569 COVID-19 vaccine doses have been administered in Ulsan city. A total of 97 cases of vaccination-related adverse ophthalmic events have been confirmed. In 21 of these cases, irreversible sequelae persisted after the side-effects. Most symptoms developed within 1 week after vaccination (mean 5.06 ± 6.86 days). The most common symptom was visual disturbance (67 cases), followed by ocular pain (19 cases) and double vision (16 cases). The most frequent diagnoses associated with irreversible sequelae were neurological diseases (7 cases), retinal diseases (5 cases), and glaucoma (5 cases). The frequencies of side effects were highest for those of BNT162b2 status (34 cases), followed by those of ChAdOx1 (30), mRNA-1273 (20), and Ad26.COV2.S (4).Conclusions: In contrast to other vaccinations, COVID-19 vaccination was viewed as urgent; a few known ophthalmic side effects developed after vaccination. Although such adverse events are rare, affected patients must be closely monitored; the sequelae may be irreversible.

Methods for improving imaging quality of a small-distance high-speed rotational reflection tracking system

The imaging quality of a rotational reflection high-speed tracking system is greatly affected by the optical characteristics of the reflector and the depth of field limitations of the imaging system, especially for tracking systems working in small distances. In order to improve the imaging quality, this paper focused on two factors that affect the imaging quality: double vision caused by the optical characteristics of reflectors and blurring caused by the depth of field of imaging systems. This paper quantified the impact of these two factors on imaging through theoretical analysis, proposed a method of changing the hardware position, and conducted a simulation and experiments. The results show that the proposed solution in this paper can effectively improve the imaging quality of the system. The content studied in this paper has certain significance in the field of high-speed tracking of rotating reflectors and can provide reference for relevant researchers.

Double Vision: Trochlear Nerve Mononeuropathy as a Rare Consequence of Cutaneous VZV (P7-14.003)

Double Vision: Trochlear Nerve Mononeuropathy as a Rare Consequence of Cutaneous VZV (P7-14.003)

Lady With Painful Double Vision

No abstract available

Diagnosis dan Tata Laksana Dissociated Vertical Deviation

Dissociated vertical deviation (DVD) is characterized by an upward deviation of one eye in the absence of any compensatory movement in the other eye. This condition is often seen in strabismus and can cause visual disturbances such as double vision and amblyopia. Its underlying causes are believed to be related to abnormalities of the visual pathways to control eye movements. Treatment options include observation, conservative management, and surgical intervention, depending on the severity and underlying cause.

"Ooh...He's Got Double Vision:" Lithium-Induced Ocular Myasthenia Gravis in An Older Adult Male

"Ooh...He's Got Double Vision:" Lithium-Induced Ocular Myasthenia Gravis in An Older Adult Male

Xu Bing's The Character of Characters and the Possibilities of Calligraphic Animation

This article examines contemporary Chinese artist Xu Bing's (b. 1955) 2012 animation video, The Character of Characters, which remediates Zhao Mengfu's (1254–1322) calligraphy and painting. The video, in which Chinese written words become the true protagonists, was originally a commissioned installation presented at the Asian Art Museum of San Francisco from October 2012 to January 2013. The article aims to model a form of extremely close analysis of new media art, which borrows vocabulary and methodologies from both art history and media studies. While making a timely contribution to Xu Bing scholarship by focusing on an understudied work in his oeuvre, it also adds new lines of inquiry: first, with regard to text-image reciprocity, which continues to be a focal point in studies of contemporary Chinese art; and second, with regard to animation-calligraphy reciprocity, which begs more critical attention. The Character of Characters, I argue, invokes a double vision that sees words on screen simultaneously as linguistic texts and pictorial shapes, a vision through which and because of which the activities of looking and reading are combined into one.

Wearable apparatus for correction of visual alignment under torsional strabismus.

A wearable optical apparatus that compensates for eye misalignment (strabismus) to correct for double vision (diplopia) is proposed. In contrast to prism lenses, commonly used to compensate for horizontal and/or vertical misalignment, the proposed approach is able to compensate for any combination of horizontal, vertical, and torsional misalignment. If the action of the extraocular muscles is compromised (e.g., by nerve damage), a patient may lose their ability to maintain visual alignment, negatively affecting their binocular fusion and stereo depth perception capability. Torsional misalignment cannot be mitigated by standard Fresnel prism lenses. Surgical procedures intended to correct torsional misalignment may be unpredictable. A wearable device able to rectify visual alignment and restore stereo depth perception without surgical intervention could potentially be of great value to people with strabismus. We propose a novel lightweight wearable optical device for visual alignment correction. The device comprises two mirrors and a Fresnel prism, arranged in such a way that together they rotationally shift the view seen by the affected eye horizontally, vertically, and torsionally. The extent of the alignment correction on each axis can be arbitrarily adjusted according to the patient's particular misalignment characteristics. The proposed approach was tested by computer simulation, and a prototype device was manufactured. The prototype device was tested by a strabismus patient exhibiting horizontal and torsional misalignment. In these tests, the device was found to function as intended, allowing the patient to enjoy binocular fusion and stereo depth perception while wearing the device for daily activities over a period of several months. The proposed device is effective in correcting arbitrary horizontal, vertical, and torsional misalignment of the eyes. The results of the initial testing performed are highly encouraging. Future study is warranted to formally assess the effectiveness of the device on multiple test patients.

Tumefactive Multiple Sclerosis: A Mimicker of Intracranial Space-Occupying Lesions

Abstract: A chronic disease of CNS, Multiple sclerosis is characterized by inflammation and demyelination with axonal injury affecting upper motor neurons of brain or spinal cord. Tumefactive multiple sclerosis is a rare form of MS which mimics intracranial tumor-like space-occupying lesions on radiography. A 25-year old gentleman presented 2-month history of gradual onset difficulty in walking, slurring of speech and double vision. The patient had an ataxic gait accentuated by tandem walking with tendency to fall towards right and a negative Romberg’s sign. There was dysarthria and signs of cerebellar lesion present on the right side. Muscle tone was normal in upper limbs but increased (spasticity) in lower limbs bilaterally. Power was normal but deep tendon reflexes were exaggerated in all 4 limbs with bilateral up-going plantar reflex. MRI scan of the brain demonstrated tumour-like tumefactive lesions in the right cerebellum, right pons and the left subcortical region with no post-contrast enhancement of these lesions. MRI of whole spine demonstrated subtle hyperintense signals in the cervical spine. He had a past history of transverse myelitis 2 years ago with full clinical recovery with oral steroids. He was diagnosed with Tumefactive Multiple Sclerosis and started on corticosteroid therapy resulting in dramatic improvement.

Influence of Dietary Seafood on the Prevention of Ocular Disorders: A Clinical Analysis

Age-related macular degeneration, retinal dysfunction, dry eye syndromes, cataract formation, and the prevalence of other vision defects are directly related to nutrients in the diet. People consuming seafood are less prone to several vision disorders. The present study was designed to validate the view. In this study, 712 visitors to tertiary eye care for eye check-ups were interviewed using a standard questionnaire, and from them, 264 persons were identified with some ocular defects. The identified cases were further screened based on their dietary habits with seafood. The isolated cases were clinically examined, and the development of ocular defects such as macular edema, optic neuropathy, myopia, double vision, dry eye syndrome, and color blindness was recorded. The results show that the respondents taking one or another type of three fishes regularly have a low impact on visual disorders. Respondents with fish intake above 500 g/week were less affected by all five ocular disabilities tested when compared with occasional users. Among the total respondents, the percentage of visual defects was seen in 62.12% in seafood users, but among the non-seafood users, the presence of visual defects was 89.6%. Statistical analysis using the Pearson population correlation coefficient, ρ (rho), further confirmed the relationship between eye wellness and a seafood diet. The omega-3 fatty acids linked with vision were also high in the fish consumed by the people. This study confirms that a regular seafood diet is good for eye health and can prevent the epidemics of several eye diseases. As fish intake contains a good amount of long-chain polyunsaturated omega-3 fatty acids, people who consume fish in their diet are less susceptible to advanced macular degeneration and other vision impairments responsible for age-related blindness.

Machiavelli’s Warning: The Medici, Florence, Rome and New Princes

In his dedication to The Prince, Machiavelli places himself in the position of the people who can discern the nature of princes; his text, however, suggests that he also, like a prince, understands the nature of the people. This double vision informs the reader throughout, as Machiavelli warns the Medici of the dangers to their rule while informing the people as to the weakness of their regime. This article further investigates the positive reference to Pope Sixtus IV, a reference that could not have endeared Machiavelli to the Medici. It then explores The Prince’s discourse around Pope Alexander VI and Cesare Borgia, both of whom would have been anathema to the Medici and Florentine people. Finally, Machiavelli draws a portrait of the new prince that echoes the hidden regal tyrant of Aristotle’s Politics. In conclusion, while Machiavelli’s Prince may have been instructive for the people, it could hardly have been favourably received by the Medici.