Adult Onset Strabismus and Diplopia
Prem S Subramanian, MD, PhD

I.     Emergent causes of diplopia
      A. Pituitary apo...
Upcoming SlideShare
Loading in …5
×

Diplopia Outline Vis Ophth

599 views
514 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
599
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
20
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Diplopia Outline Vis Ophth

  1. 1. Adult Onset Strabismus and Diplopia Prem S Subramanian, MD, PhD I. Emergent causes of diplopia A. Pituitary apoplexy B. Aneurysmal CN III palsy C. CN VI palsy with papilledema II. Categories of disease A. Neurological 1. Supranuclear disorders 2. Nuclear/fascicular 3. Cranial nerve palsy 4. Phoria decompensation B. Orbital/muscular 1. Thyroid eye disease 2. Orbital tumor 3. Infiltrative disease 4. Orbital pseudotumor C. Neuromuscular junction disease 1. Myasthenia gravis 2. Eaton-Lambert myasthenia 3. Other III. Diagnostic Approach A. Clinical examination 1. Observation of head postures 2. Prism and cover testing 3. Alternative diplopia measurement techniques B. Ancillary testing 1. Ice and rest testing 2. Forced duction testing 3. Prostigmin vs Tensilon testing 4. Orbital echography 5. Neuroimaging study- what to order, and when? 6. Lab studies IV. Management A. Patching vs. tape occlusion B. Temporary (Fresnel) prism C. Strabismus surgery vs chronic prism use

×