A Practical Approach to a Patient Presenting with Acute Diplopia
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Abstract
Acute diplopia is a common presenting symptom in ophthalmic practice and often indicates potentially serious underlying conditions. A structured diagnostic approach begins with detailed history taking and physical examination to distinguish between monocular and binocular diplopia. In binocular cases, further assessment of the deviation pattern - horizontal, vertical, or oblique - guides localization and differential diagnosis. Ancillary investigations such as computed tomography (CT) or magnetic resonance imaging (MRI), together with laboratory tests, assist in identifying major causes, including microvascular ischemia, inflammation, and infection. Management depends primarily on the underlying etiology and may require a multidisciplinary approach involving neurology and endocrinology. For persistent diplopia, symptomatic treatment options include prism glasses, botulinum toxin injections, or strabismus surgery. A systematic evaluation not only facilitates timely diagnosis but also improves patient outcomes through targeted management.
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