Diplopia is an ophthalmic pathology. Causes, varieties, methods of treatment of diplopia

Diplopia is a disease of the visual system, which is characterized by impaired functioning of the oculomotor muscles, leading to bifurcation of the visible image. In this case, the image shift can be vertical, horizontal and even diagonal.

A little information

A person with normal vision sees the object clearly with two eyes. This mechanism works well by creating a common image in the brain. And diplopia is a phenomenon in which the patient sees two pictures of one whole. Usually this pathology does not exist independently, but is associated with any disease. In addition, cases of congenital diplopia are known.

Types of disease

There are several varieties of this pathology:

1. Binocular diplopia is characterized by a lack of high-quality images on the retina. This is due to a shift in the visual axis of one of the eyes. This variety is divided into sensory, strabogenic, motor, orbital, mixed disease. With this type of pathology, when one eye is closed, the image ceases to double.
2. Monocular diplopia, which is characterized by the display of a picture visible with one eye, simultaneously in two places of the retina. Typically, this phenomenon occurs due to an inflammatory process in the iris or fogging of the lens. If you close the second eye, double vision with this type of diplopia will not disappear.
3. Paralytic pathology develops due to paralysis of one or more eye muscles.
4. Cross view in which the image is projected crosswise. In other words, the picture that refers to the right eye is visible on the left, and vice versa. Such a pathology causes maximum discomfort in a sick person.

Types of the most common disease

As for the varieties of binocular diplopia:

• strabogenic pathology develops in patients with different forms of strabismus;
• orbital may occur after surgery on the visual organs;
• restrictive occurs against the background of eye injury along with constricted motor muscles or a change in the normal location of the apple.

Clinical picture

First of all, diplopia is a consequence of myasthenia gravis. It occurs due to a variety of failures of the main departments of the visual system and disturbances in the muscular balance of various nature. This pathological condition leads to a decrease in organ mobility or to lateral movement of the eye. In addition, diplopia can be caused by pathological changes occurring in the orbit, causes of a neurogenic nature.

The disease develops with myasthenia gravis or paralysis of the eye muscles responsible for the movement of the visual organ. In this case, the consistency of eyeballs is lost. In addition, in some cases, diplopia is a sign of trauma to the nerves that are responsible for the functioning of the muscles.

Risk groups

Among other things, there are several more common causes of diplopia:

• various hematomas and tumors that interfere with the mobility of the eye or lead to complete paralysis;
• inflammation of the cornea - an untimely cured disease can lead to complications such as damage to muscles and nerves;
• diabetic neuropathy is one of the forms of diabetes complications that can occur in patients with a long period of illness;
• disorders of the thyroid gland and the endocrine system as a whole;
• displacement of the orbit due to destructive processes inside;
• an increase in the dosage of cosmetic Botox can lead to neuromuscular conduction;
• trauma to the orbit, which often occurs after damage to the lower border of the eye or pinching of the muscles;
• expansion of the carotid artery, which as a result pinches the nerve;
• vegetovascular dystonia can lead to an idiopathic form of diplopia, in which case the disease lies in psychological problems;
• skull injuries, due to which the oculomotor nerve is destroyed.

Accompanying illnesses

In addition, diplopia can be the result of other serious pathologies:

1. Neoplasms inside the skull, tuberculous meningitis, stroke, multiple sclerosis and other diseases of a neurological nature.
2. Strong intoxication, which arose due to the use of alcohol or medications.
3. Botulism, in which, due to damage to the nervous system, signs appear similar to a weakening of the muscles of the eye.
4. Diphtheria, rubella, tetanus, and mumps are pathologies that damage the brain stem and affect the central nervous system.
5. Thyrotoxicosis, due to which the muscles of the eye swell, and movement becomes difficult.
6. Diabetes mellitus, in which the disease is secondary and goes away on its own with a risk of relapse.
7. Surgical intervention in the brain, which was performed to eliminate cataracts, strabismus, retinal detachment.
8. Mental neurosis and bouts of hysteria.

Occasionally, even in completely healthy people there is a split in the eyes when looking at objects due to lack of sleep, too hard physical or intellectual work, temporary intoxication of the body.

Symptoms

Manifesting signs of the disease depend on exactly where the failure occurred. For example, if the oblique muscles are injured, then the bifurcation occurs as the placement of one object over another.

In case of damage to the rectus muscles, diplopia will take on a parallel character. In general, this pathology is characterized by various stages of deviation of the eyes to the side opposite to the injured tissues.

As a result, there is a restriction of movement or even its complete absence. Often patients, in order to at least somehow deal with discomfort, are forced to tilt or turn their heads.

Among the most common symptoms of diplopia are:

• actually bifurcation of the image;
• difficulties during determining the location of objects;
• regular dizziness.

Features

Two identical pictures can vary significantly in saturation and contrast. One image can be moved vertically or horizontally and placed at a certain angle with respect to the second.

With meningitis, skull injuries, infectious diseases, tumors, pathologies of the vascular system, the symptoms of diplopia will be combined with the signs characteristic of these diseases. In the case of diphtheria, bifurcation may occur at the peak of the disease. If we are talking about botulism, then diplopia will be one of the initial symptoms.

Diagnostics

Any patient can be diagnosed with double vision only in a specialized ophthalmological center. Diagnosis is necessary to determine the location of the failure, to identify the causes of the pathological condition and further forecast. This disease has a strong effect on:

• the eye itself;
• nerve;
• auxiliary ocular apparatus;
• brain.

Diagnosis involves the implementation of classical manipulations in the form of visiometry and ophthalmoscopy. In addition, a thorough examination of the conjunctiva, contrast perception, analysis of the refraction of light rays and visual acuity is performed. After all these manipulations, the specialist listens to the patient’s complaints.

Ancillary examinations are performed using MRI, CT and ultrasound. If necessary, the doctor can give the patient a referral for consultation with other specialists: oncologist, rheumatologist, dermatovenerologist, neurophthalmologist, psychiatrist, endocrinologist, neurologist.

If the patient has strabismus, diplopia of the eye is diagnosed by provocation and coordinate measurement. These techniques imply test control of visual acuity and quality. The patient should look at a moving light source for some time. The resulting image is transferred to a special coordinate map. In this way, the specialist is able to determine the defeat of a particular muscle.

How and where to treat diplopia

A patient who has been diagnosed with this should understand that such symptoms can immediately lead to serious illnesses and complications. And in order to avoid possible problems it is urgent to seek help from a specialist.

Therapy with such a disease is aimed at eliminating the cause of its occurrence. The treatment itself is performed on an outpatient basis, under the supervision of a qualified optometrist in a specialized ophthalmological center. There are several effective treatment methods:

1. Elimination of volumetric pathologies in the orbit - for example, puncture of a hematoma, as well as removal of neoplasms.
2. Treatment of stroke, as well as all kinds of neuropathic and neurological failures.
3. Treatment of inflammatory and infectious pathologies, which is performed with the help of diuretics, anti-inflammatory drugs and antibiotics.
4. The treatment of the underlying disease is a correction for the resumption of the full functioning of the optic nerve.
5. If the cause of the disease lies in intoxication, the first step is to cleanse the entire body.
6. The occlusion technique is used when several nerves are affected simultaneously. This method involves the failure of one eye. The specialist offers the patient special contact lenses or gluing a special tape on the glasses.
7. Prismatic therapy to reduce the manifestations of pathology. In this case, the specialist prescribes the use of special glasses made to order, which have a lens displaced in the middle. In addition, 6 prismatic diopters are often used for each eye.
8. Surgical intervention. Such an operation involves the displacement of the damaged muscle a little back, and the crossed tendon is sewn to the sclera. In some cases, the tissue is slightly shortened to compensate for the functioning of other organs.

Physiotherapy

Eye exercises for diplopia. This is a special gymnastics aimed at increasing the field of view and its stabilization. Effective exercises can be performed at home.

To do this, you need to fix a piece of paper on the wall, after drawing a strip on it. Then you should fix your gaze on this line, while turning your head in opposite directions.

The goal of such gymnastics is to keep the picture holistic. This exercise is effective only with an incomplete manifestation of pathology. If the patient is diagnosed with sensory diplopia, he needs to combine two bands in one picture.

ethnoscience

The treatment of diplopia can consist not only in traditional methods. No less effective were popular recipes in the fight against manifestations of pathology:

1. Tincture based on white wine, dry valerian and lavender leaves. These ingredients must be mixed and infused for at least three days. Dishes with liquid should be shaken periodically. After the tool is ready, it will only be strain. Tincture should be consumed about half an hour before a meal, one spoonful daily.
2. Flower pollen is also famous for its healing qualities. For a month, you should take a teaspoon of this substance in the morning and evening.
3. Vitamin fees. Such a medicine should be drunk constantly. Tincture can be made from rose hips and viburnum, for example. The components in equal amounts must be poured with water and boiled for 15 minutes over low heat. After cooling, the liquid must be filtered. Use the product should be 100 ml twice a day.

Diplopia Prevention

This disease has an unpredictable prognosis of the course, therefore, preventive measures in this case can only be general strengthening. You can minimize the risk of diplopia if:

• get rid of all sorts of bad habits, for example, smoking tobacco or drinking alcohol;
• lead an active lifestyle - organize hiking, training, and exercise every day;
• observe the correct regimen - sleep should last at least eight hours;
• systematically pass all the necessary examinations;
• constantly monitor blood pressure;

In case of the slightest symptoms, you should immediately contact a specialist.