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Diplopia, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Double vision

    • Simultaneous perception of 2 images

    • Can be oriented horizontally, vertically, or diagonally from one another.

  • Diplopia is usually due to abnormal movement of the extraocul...

Diagnosis

Signs and Symptoms

History

  • Determine if the diplopia is following head injury, if it is constant or intermittent and its duration.

  • Determine if diplopia is monocular or binocular.

  • Ask about HA o...

Treatment

Initial Stabilization/Therapy

The vast majority of patients with diplopia do not require stabilization. Initial steps are entirely based on the etiology in an individual patient. 

Ed Treatment/Procedures

Follow-Up

Disposition

Admission Criteria

  • Admission is predicated upon the cause.

  • Many patients are admitted to facilitate a rapid workup for serious causes (including advanced brain and vascular imaging ...

Pearls and Pitfalls

  • Diplopia can present as “blurred vision” if the 2 images are not far off from one another.

  • Never assume diplopia is an isolated cranial neuropathy without doing a very careful neuro...

Additional Reading

  • Brazis  PW. Isolated palsies of cranial nerves III, IV, and VI. Semin Neurol.  2009;29:14–28.

  • Buracchio  T, Rucker  JC. Pearls and oysters of localization in ophthalmoparesis. N...

Codes

ICD9

  • 368.2 Diplopia

  • 368.15 Other visual distortions and entoptic phenomena

ICD10

H53.2 Diplopia 

SNOMED

  • 24982008 Diplopia (disorder)

  • 50446000 Monocular diplopia (disorder)

  • 246655008 double vision with b...

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