Diplopia: Points to Consider

Summary: • Diplopia (seeing two images) can be grouped into being binocular or monocular o Binocular diplopia involves both eyes being open -One eye looks at target while the other does not -Covering one of either eye makes double vision disappear -Treatment requires neuro-ophthalmology • Can affect many parts of the visual pathway (i.e. nerve, neuromuscular junction, muscle) o Monocular diplopia involves one eye being affected -Only covering affected eye makes double vision go away • Covering unaffected eye results in double vision remaining (way to differentiate the two types of diplopia) -Etiology is usually ocular • i.e. dry eyes, corneal disease, refractive disease, cataracts -Can be unilateral or bilateral -Can be corrected using the pinhole test • Central beam of light passing through pinhole does not require much refraction • Eliminates stray light beams to eliminate monocular diplopia [Questions] Q: I see 2 images of anything that's not in focus. Like if I focus on my hand, everything in the background I see as 2 images, and vice versa. Is that diplopia? A: Yes, but it is a normal form of diplopia termed physiological diplopia. Though the brain can usually suppress this effect, some people notice the diplopia on unfocused objects, resulting in this